Barlow Karen Maria
Division of Pediatric Neurology, Faculty of Medicine, University of Calgary, Alberta Children's Hospital, Calgary, Canada.
Handb Clin Neurol. 2013;112:891-904. doi: 10.1016/B978-0-444-52910-7.00011-8.
In childhood, traumatic brain injury (TBI) poses the unique challenges of an injury to a developing brain and the dynamic pattern of recovery over time, inflicted TBI and its medicolegal ramifications. The mechanisms of injury vary with age, as do the mechanisms that lead to the primary brain injury. As it is common, and is the leading cause of death and disability in the USA and Canada, prevention is the key, and we may need increased legislation to facilitate this. Despite its prevalence, there is an almost urgent need for research to help guide the optimal management and improve outcomes. Indeed, contrary to common belief, children with severe TBI have a worse outcome and many of the consequences present in teenage years or later. The treatment needs, therefore, to be multifaceted and starts at the scene of the injury and extends into the home and school. In order to do this, the care needs to be multidisciplinary from specialists with a specific interest in TBI and to involve the family, and will often span many decades.
在儿童时期，创伤性脑损伤（TBI）带来了独特的挑战，包括发育中的大脑受到损伤、随着时间推移的动态恢复模式、外伤性脑损伤及其法医学后果。损伤机制随年龄而异，导致原发性脑损伤的机制也是如此。由于其常见性，且是美国和加拿大死亡和残疾的主要原因，预防是关键，我们可能需要加强立法来促进这一点。尽管其普遍存在，但几乎迫切需要开展研究以帮助指导最佳管理并改善治疗结果。事实上，与普遍看法相反，重度创伤性脑损伤儿童的预后较差，许多后果在青少年时期或更晚才显现出来。因此，治疗需要多方面进行，从受伤现场开始，延伸至家庭和学校。为了做到这一点，护理需要由对创伤性脑损伤有特定兴趣的专家进行多学科协作，并让家庭参与其中，而且通常会持续数十年。
