ECMO-/ECLS

(^)
Chapter 13
PEDIATRIC NEUROTRAUMA
Alessandra Gasior, DO
David Juang, MD
(^) I. Introduction
Traumatic brain injuries (TBI) are a leading cause of morbidity and
mortality in the pediatric population and account for more than half of all injuries
sustained [1]. Approximately 37,000 children ages 14 years old or less are
admitted to hospitals every year for TBI. Annually nearly 3000 children will die
from TBI [2].^ Head trauma commonly occurs due to falls, motor vehicle
accidents, sports accidents, as well as non-accidental trauma (NAT). In the
United States, children account for 30% of the TBI patients each year [3].
There is a bimodal age distribution: 0-4 years old and 15-19 years old.
Moreover, the highest mortality rates occur in children younger than 2 years old
and older than 15 years old. Males are twice as likely as females to be affected
by TBI [4]. Infants and toddlers are more likely to suffer from falls, motor
vehicle accidents, accidental blows to the head and child abuse, in order of
frequency. These three mechanisms are also the highest contributors to brain
injury in regards to total billed charges and account for more than $1 billion in
total charges over a 5 year period [5]. Unlike adults, children have structural
limitations that cause them to be more susceptible to changes in head inertia.
The infant brain doubles its size during the first 6 months of life. By the age of