Traumatic brain and spinal cord injury

The management of pediatric head injuries has evolved over the past decade, and a number of significant advances have been made. Evidence-based guidelines and algorithms for the management of severe pediatric head injuries have recently been published (Fig. 7) Fig. 7 Proposed management algorithm for the management of severe head injuries in children. (A) Primary therapies. (B) Second tier therapies. (From Adelson PD, Bratton SL, Carney NA, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Pediatr Crit Care Med 2003;4(3 Suppl):S175; with permission.), and all pediatricians who care for children with severe head injuries should be familiar with these guidelines. It is hoped the guidelines will streamline the clinical management of these children and stimulate future research into the many areas that require further investigation.