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Updated: Jan 14, 2026
A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Intensive care for pediatric traumatic brain injury
A Sigurtà1, C Zanaboni, K Canavesi
1Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Neurointensive Care Unit and University of Milan, Milan, Italy. anna.sigurta@unimi.it
Insights
Pediatric head injuries often cause high intracranial pressure (ICP). Early intensive care and surgical treatment improve outcomes, with Glasgow Coma Scale motor score, pupils, and ICP predicting results.
Area of Science:
- Pediatric neurosurgery
- Intensive care medicine
- Trauma surgery
Background:
- Traumatic brain injury (TBI) in children presents unique challenges.
- Intracranial pressure (ICP) management is critical for pediatric TBI outcomes.
- Current practices for ICP monitoring and treatment in pediatric head injury require evaluation.
Purpose of the Study:
- To characterize a cohort of pediatric head injury patients.
- To describe current ICP monitoring and treatment strategies.
- To identify predictors of 6-month outcomes in pediatric head injury.
Main Methods:
- Retrospective review of a prospectively collected database from three neuro-ICUs.
- Inclusion of patients younger than 19 years, stratified by age group.
- Analysis of ICP and cerebral perfusion pressure (CPP), with outcome assessed by Glasgow Outcome Score at 6 months.
Main Results:
- 199 pediatric patients included; 60% had extracranial injuries.
- ICP monitoring was performed in 117 patients, with 87 showing ICP > 20 mmHg.
- Mortality was 21%, with 72% achieving favorable outcomes; Glasgow Coma Scale (GCS) motor score, pupils, and ICP were significant outcome predictors.
Conclusions:
- Pediatric head injury frequently involves intracranial hypertension.
- Prompt surgical intervention and intensive care management are crucial.
- Effective management strategies can lead to favorable outcomes in most pediatric TBI cases.
Purposes:
The aims of this study are to describe a cohort of head-injured pediatric patients, focusing on current practice for intracranial pressure (ICP) monitoring and treatment and to verify the relationship between clinical and radiological parameters and the six-month outcome in a multivariable statistical model.
Methods:
A retrospective review was done of a prospectively collected database considering patients younger than 19 years admitted to three neuro-intensive care units (ICU). Patients were divided into four age groups: 0-5 (infant), 6-12 (children), 13-16 (pre-adolescent) and 17-18 years (adolescent). The ICP and cerebral perfusion pressure (CPP) were analyzed calculating average data and values exceeding thresholds for more than 5 min. Outcome was assessed 6 months after trauma using the Glasgow Outcome Score.
Results:
There were 199 patients, 155 male, included. Sixty percent had extracranial injuries. Pupils were abnormal in 38 %. Emergency evacuation of intracranial hematomas was necessary in 81 cases. The ICP was monitored in 117 patients; in 87 cases ICP was higher than 20 mmHg, with no differences among age groups. All but six patients received therapy to prevent raised ICP; barbiturates, deep hyperventilation or surgical decompression were used in 31 cases. At 6 months, mortality was 21 % and favorable outcome was achieved by 72 %. Significant predictors of outcome in the multivariable model were the Glasgow Coma Scale (GCS) motor score, pupils and ICP.
Conclusions:
Pediatric head injury is associated with a high incidence of intracranial hypertension. Early surgical treatment and intensive care may achieve favorable outcome in the majority of cases.
