Accidental and Nonaccidental Injury of the Pediatric Brain and Spine

Abstract

Traumatic brain and/or spine injury (TBSI) is a leading cause of morbidity and mortality in children [1, 2]. Traumatic injury in children differs significantly from adults in multiple aspects. Clinical assessment is frequently challenging, details about the neurological symptoms at the time of injury may be lacking, and the type of trauma varies with the child’s age and physical activity. In addition, the pediatric skull, spinal column, and their contents undergo continuous anatomical and functional development. Consequently, the extent, quality, and distribution of injury, primary and secondary complications, neurological deficits, and functional outcome are very different for each age group [3]. Computer tomography (CT) and magnetic resonance imaging (MRI) have revolutionized diagnosis, management, and treatment options for children with TBSI. Early diagnosis of the exact extent and quality of TBSI may improve outcome by limiting and preventing devastating complications [4]. More recently, advanced functional imaging techniques such as diffusionweighted imaging (DWI), perfusion-weighted imaging (PWI), and susceptibility-weighted (SWI) MRI allow early characterization of different mechanical, physiological, and hemodynamic processes that may lead to lasting neurological deficits.