[Severe pediatric head injury: is there any optimal solution?]

Area of Science:

• Pediatric neurology
• Trauma surgery
• Emergency medicine

Background:

• Traumatic brain injury (TBI) is a significant global health concern, with increasing incidence worldwide.
• Lithuania faces a notably higher rate of pediatric trauma cases compared to developed European nations.
• Effective management strategies are crucial to mitigate the severe consequences of pediatric TBI.

Purpose of the Study:

• To review modern management approaches for pediatric traumatic brain injury (TBI).
• To highlight the importance of prehospital care and specialized trauma centers in improving outcomes.
• To discuss the critical role of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) management.

Main Methods:

• Review of current literature and data on pediatric TBI management.
• Emphasis on prehospital care elements: airway management, ventilation, oxygenation, and perfusion.
• Discussion of trauma system establishment and pediatric trauma center protocols.
• Analysis of triage systems, ICP monitoring, and management of intracranial hypertension.

Main Results:

• Effective prehospital care is vital to prevent secondary brain injury.
• Treatment within dedicated pediatric trauma centers demonstrably reduces mortality and enhances patient outcomes.
• Timely management of elevated intracranial pressure (ICP) is directly linked to improved survival and recovery rates.

Conclusions:

• A coordinated trauma system with specialized pediatric trauma centers is essential for optimal TBI care.
• Implementing standardized triage and scoring systems aids in appropriate patient management.
• Aggressive management of intracranial pressure, guided by monitoring, is a cornerstone of successful pediatric TBI treatment.