Management of severe pediatric head trauma

Except for prevention, nothing can alter the primary damage to the central nervous system tissues and blood vessels caused by the impact of traumatic forces over a few milli-seconds. However, damage to nervous system tissues secondary to transient reversible brain dysfunction may occur and lead to failure of respiration and circulation. Brain swelling and intracranial hypertension can develop and interfere with oxygen delivery and cellular metabolism of vital central nervous structures. A team approach with simultaneous treatment of the various disorders and recurrent evaluation is the hallmark of successful management.