Department of Neurosurgery, Dell Medical School, University of Texas at Austin, Austin, TX, USA.
Adv Neurobiol. 2024;42:3-19. doi: 10.1007/978-3-031-69832-3_1.
There are a number of challenges in the management of acute traumatic brain injuries in children. Beyond their relatively broad age range, which spans neonates to late adolescence, these children may likewise present with coexisting injuries. Thus, their management often necessitates a multidisciplinary team, who coordinate medical/surgical management during their hospitalization in the intensive care unit, as well as specialists in pediatric neurology and rehabilitation during postoperative recovery. Here we address standard of care for acute management, based upon established guidelines and focusing on intracranial pressure, cerebral perfusion pressure, and autoregulation. We also consider the controversies related to monitoring intracranial pressure and methods for sedation and treatment.
儿童急性创伤性脑损伤的管理存在诸多挑战。除了年龄范围相对较宽（从新生儿到青春期后期）之外，这些儿童还可能同时存在其他损伤。因此，他们的管理通常需要多学科团队，这些团队在他们住院期间的重症监护病房中协调医疗/手术管理，以及儿科神经学和康复方面的专家在术后恢复期间进行协调。在这里，我们根据既定指南讨论急性管理的标准护理，重点关注颅内压、脑灌注压和自动调节。我们还考虑了与颅内压监测相关的争议以及镇静和治疗方法。
