Acute and Long-Term Outcomes Following Pediatric Traumatic Brain Injury

Pediatric traumatic brain injury (TBI) is one of the leading causes of death and serious disability among children and adolescents. Incidence and prevalence rates of pediatric TBI are often difficult to obtain and vary by injury severity as well as mechanism of injury. In a recent report, the Centers for Disease Control and Prevention (CDC) reported that children aged 0 to 4 years and adolescents aged 15 to 19 years display the highest incidence rates of TBI-related emergency department visits and/or hospitalizations.1Amajorityof pediatric TBI aremild ( 80%),whereas a smaller percentage of injuries are moderate to severe.2,3 Despite physiological commonalities, the immature or developing brain likely responds differently to trauma than the mature adult brain.4 Children are more likely to experience posttraumatic edema, ischemic insult, and diffuse rather than focal injuries, whichmay be due to differing biomechanical properties of the developing brain. This may be related to the fact that children have a greater head-to-body ratio, less myelination, and a greater relative proportion of water content and cerebral blood volume compared with adults.5 The trajectory of recovery is known to be more variable in children compared with adults.