Pathophysiology and management of moderate and severe traumatic brain injury in children

Kristin Guilliams*, Mark S. Wainwright

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Traumatic brain injury remains a leading cause of morbidity and mortality in children. Key pathophysiologic processes of traumatic brain injury are initiated by mechanical forces at the time of trauma, followed by complex excitotoxic cascades associated with compromised cerebral autoregulation and progressive edema. Acute care focuses on avoiding secondary insults, including hypoxia, hypotension, and hyperthermia. Children with moderate or severe traumatic brain injury often require intensive monitoring and treatment of multiple parameters, including intracranial pressure, blood pressure, metabolism, and seizures, to minimize secondary brain injury. Child neurologists can play an important role in acute and long-term care. Acutely, as members of a multidisciplinary team in the intensive care unit, child neurologists monitor for early signs of neurological change, guide neuroprotective therapies, and transition patients to long-term recovery. In the longer term, neurologists are uniquely positioned to treat complications of moderate and severe traumatic brain injury, including epilepsy and cognitive and behavioral issues.

Original languageEnglish (US)
Pages (from-to)35-45
Number of pages11
JournalJournal of child neurology
Issue number1
StatePublished - Jan 2016


  • Closed head injury
  • Intracranial pressure
  • Pediatric brain trauma
  • Pediatric neurocritical care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology


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