Department of Pediatric Neurosurgery, Hospices Civil de Lyon, Hôpital Femme Mere Enfant, 59 Bvd Pinel, 69500, Bron, France.
Childs Nerv Syst. 2022 Dec;38(12):2289-2294. doi: 10.1007/s00381-022-05650-0. Epub 2022 Sep 2.
Pediatric neurosurgeons are at the forefront of the clinical management of abusive head injuries (AHI) all over the world. However, the discrepancies regarding medical practice and legal requirements in different centers have not been assessed before.
We decided to perform an online survey among members of the International Society for Pediatric Neurosurgery (ISPN) regarding their activity, their usual clinical practice regarding the medical and legal management of AHI, and their involvement in judiciary proceedings, research, and prevention campaigns.
Ninety members of the ISPN participated in the survey, representing 26% of the registered members. Most responders were senior pediatric neurosurgeons practicing in a university hospital. Their responses show great homogeneity regarding surgical, intensive care, and legal management. We also noted the widespread use of invasive intracranial pressure monitoring and decompressive craniotomy. By contrast, the responses show great disparity regarding the circuit of patients. This disparity may be an obstacle to the collection of data and clinical research, as well as for the involvement of neurosurgeons in multidisciplinary evaluation. A minority of neurosurgeons were engaged in research and actions of prevention.
Pediatric neurosurgeons play a pivotal role in the diagnosis and medical management of AHI. Because of their proficiency in head trauma and cerebrospinal fluid disorders, it is desirable that they become more implicated in multidisciplinary meetings, medical expertise, and scientific research, as well as actions of prevention.
小儿神经外科医生在全世界范围内处于虐待性头部损伤（AHI）临床管理的前沿。然而，之前尚未评估过不同中心之间的医疗实践和法律要求的差异。
我们决定在国际小儿神经外科学会（ISPN）的成员中进行一项在线调查，调查他们的活动、他们在 AHI 的医疗和法律管理方面的常规临床实践以及他们在司法程序、研究和预防活动中的参与情况。
90 名 ISPN 成员参与了调查，占注册成员的 26%。大多数应答者是在大学医院工作的资深小儿神经外科医生。他们的回答在手术、重症监护和法律管理方面显示出高度的一致性。我们还注意到广泛使用侵入性颅内压监测和减压性颅骨切开术。相比之下，对患者的处理方式存在很大差异。这种差异可能会对数据收集和临床研究以及神经外科医生参与多学科评估造成障碍。少数神经外科医生参与了研究和预防活动。
小儿神经外科医生在 AHI 的诊断和医疗管理中发挥着关键作用。由于他们在头部创伤和脑脊液疾病方面的专业知识，我们希望他们更多地参与多学科会议、医疗专业知识和科学研究以及预防活动。
