Journal club: National variability in intracranial pressure monitoring and craniotomy for children with moderate to severe traumatic brian injury

摘要

Traumatic injury is the number one cause of morbidity and mortality in the pediatric population. Of the 14 million injuries occurring each year in the United States to children younger than 15 years of age, head injury is the leading cause of death and permanent disability. Although significant progress in the evidence-based evaluation and treatment of traumatic brain injury (TBI) has been made, important knowledge gaps remain, and current practices are frequently supported by low-quality evidence derived from retrospective studies. This is particularly true in the setting of pediatric TBI, where current practice is largely based on extrapolation from the adult literature, despite important differences in circumstance and pathophysiology of injury and the clinical evaluation of TBI in infants, toddlers, and adolescents. In this context, the study by Van Cleve et al provides a "snapshot" of national practices regarding the use of intracranial pressure monitoring and craniectomy/craniotomy in the treatment of significant pediatric TBI.