Araki Takashi, Yokota Hiroyuki, Morita Akio
Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital.
Neurol Med Chir (Tokyo). 2017 Feb 15;57(2):82-93. doi: 10.2176/nmc.ra.2016-0191. Epub 2017 Jan 20.
Traumatic brain injury (TBI) is the leading cause of death and disability in children. Pediatric TBI is associated with several distinctive characteristics that differ from adults and are attributable to age-related anatomical and physiological differences, pattern of injuries based on the physical ability of the child, and difficulty in neurological evaluation in children. Evidence suggests that children exhibit a specific pathological response to TBI with distinct accompanying neurological symptoms, and considerable efforts have been made to elucidate their pathophysiology. In addition, recent technical advances in diagnostic imaging of pediatric TBI has facilitated accurate diagnosis, appropriate treatment, prevention of complications, and helped predict long-term outcomes. Here a review of recent studies relevant to important issues in pediatric TBI is presented, and recent specific topics are also discussed. This review provides important updates on the pathophysiology, diagnosis, and age-appropriate acute management of pediatric TBI.
创伤性脑损伤(TBI)是儿童死亡和残疾的主要原因。小儿创伤性脑损伤具有几个与成人不同的独特特征,这可归因于与年龄相关的解剖学和生理学差异、基于儿童身体能力的损伤模式以及儿童神经学评估的困难。有证据表明,儿童对创伤性脑损伤表现出特定的病理反应,并伴有独特的神经症状,人们已经做出了相当大的努力来阐明其病理生理学。此外,小儿创伤性脑损伤诊断成像技术的最新进展有助于准确诊断、适当治疗、预防并发症,并有助于预测长期预后。本文对小儿创伤性脑损伤重要问题的近期研究进行了综述,并讨论了近期的具体主题。这篇综述提供了小儿创伤性脑损伤病理生理学、诊断和适合年龄的急性管理方面的重要更新。