在儿童创伤性脑损伤后,水头的发育考虑:叙事审查
Olubunmi A Fariyike1,2, Laura S Blackwell3,4,5, Paolo Frassanito6
1School of Medicine, Stanford University, Stanford, California, USA.
Brain injury
|March 4, 2026
概括
儿童的创伤后脑水 (PTH) 是创伤性脑损伤 (TBI) 的严重并发症. 早期识别和干预对于患有PTH的儿科患者获得更好的结果至关重要.
科学领域:
- 儿科神经外科 儿科神经外科
- 儿科神经学 儿科神经学
- 创伤性脑损伤 (TBI) 研究研究
背景情况:
- 创伤后脑水 (PTH) 是创伤性脑损伤 (TBI) 后的一种罕见但严重的并发症.
- 儿童中枢神经系统的发育影响PTH病理生理学,诊断和治疗不同于成年人.
研究的目的:
- 审查目前关于儿科PTH的证据.
- 突出儿童发育病理生理学对易感性,诊断和结果的影响.
主要方法:
- 文献综述综合了关于儿科PTH的现有研究.
- 分析影响PTH发展,临床表现和管理的因素.
主要成果:
- 年龄较小 (5岁以下) 和受伤严重程度是儿科PTH的关键预测因素.
- 临床表现不同,从急性恶化到慢性神经发育回归.
- 由于症状重叠,诊断是具有挑战性的,并且可以区分水脑病和腹腔大脑病.
- 管理涉及脑脊液 (CSF) 通过外部心室排水 (EVD) 或转转移.
结论:
- 尽管进行了手术,但儿科PTH的长期发病率显著.
- 强调儿童TBI幸存者的预防,早期检测和全面的多学科后续对儿童TBI幸存者的关键需求.
相关概念视频
Hemorrhagic Stroke ll: Pathophysiology
30
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
30
Traumatic Brain Injury l: Introduction
25
DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
25
Increased Intracranial Pressure l: Introduction
27
Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
27
Increased Intracranial Pressure ll: Pathophysiology
20
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
20
Cerebral Edema l: Introduction
30
Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
30
Cerebral Edema ll: Pathophysiology
19
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
19


