Sleep-Wake Disturbances and Fatigue after Pediatric Traumatic Brain Injury: A Systematic Review of the Literature

We performed a systematic review of the literature to evaluate pterins as biomarkers of mechanical and impact-induced trauma. MEDLINE and Scopus were searched in March 2019. We included in vivo human studies that measured a pterin in response to mechanical or impact-induced trauma with no underlying prior disease or complication. We included 40 studies with a total of 3829 subjects. Seventy-seven percent of studies measured a significant increase in a pterin, primarily neopterin or total neopterin (neopterin + 7,8-dihydroneopterin). Fifty-one percent of studies measured an increase within 24 h or trauma, while 46% measured increases beyond 48 h. Pterins also showed promise as predictors of post-trauma complications such as sepsis, multi-organ failure and mortality. Exercise-induced trauma and traumatic brain injury caused an immediate increase in neopterin or total neopterin, while patients of multiple trauma had elevated pterin levels that remained above baseline for several days. Pterin concentration changes in response to surgery were variable with patients undergoing cardiac surgery having immediate and sustained pterin increases, while hysterectomy, liver resection or hysterectomy showed no change. This review provides systematic evidence that pterins, in particular neopterin and total neopterin, increase in response to multiple forms of mechanical or impact-induced trauma.

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Pediatric traumatic brain injury and antisocial behavior: are they linked? A systematic review

Brain Injury ◽

10.1080/02699052.2019.1641621 ◽

2019 ◽

Vol 33 (10) ◽

pp. 1272-1292

Author(s):

Giulia Bellesi ◽

Edward D. Barker ◽

Laura Brown ◽

Lucia Valmaggia

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Antisocial Behavior ◽

Pediatric Traumatic Brain Injury

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Systematic Review of Clinical Research on Biomarkers for Pediatric Traumatic Brain Injury

Journal of Neurotrauma ◽

10.1089/neu.2012.2545 ◽

2013 ◽

Vol 30 (5) ◽

pp. 324-338 ◽

Cited By ~ 73

Author(s):

Linda Papa ◽

Michelle M. Ramia ◽

Jared M. Kelly ◽

Stephen S. Burks ◽

Artur Pawlowicz ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Clinical Research ◽

Pediatric Traumatic Brain Injury

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Physiotherapy after traumatic brain injury: A systematic review of the literature

Brain Injury ◽

10.1080/02699050801998250 ◽

2008 ◽

Vol 22 (5) ◽

pp. 365-373 ◽

Cited By ~ 34

Author(s):

Stephanie Hellweg ◽

Sönke Johannes

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Review Of The Literature

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Pediatric Mild Traumatic Brain Injury: Who Can Be Managed at a Non-pediatric Trauma Center Hospital? A Systematic Review of the Literature

The American Surgeon ◽

10.1177/00031348211050804 ◽

2021 ◽

pp. 000313482110508

Author(s):

Olivia A. Keane ◽

Mauricio A. Escobar ◽

Lucas P. Neff ◽

Ian C. Mitchell ◽

Joshua J. Chern ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Trauma Center ◽

Pediatric Trauma ◽

Evidence Based ◽

Review Of The Literature ◽

Mild Tbi ◽

Pediatric Tbi ◽

Pediatric Trauma Center

Background Pediatric traumatic brain injury (TBI) affects about 475,000 children in the United States annually. Studies from the 1990s showed worse mortality in pediatric TBI patients not transferred to a pediatric trauma center (PTC), but did not examine mild pediatric TBI. Evidence-based guidelines used to identify children with clinically insignificant TBI who do not require head CT were developed by the Pediatric Emergency Care Applied Research Network (PECARN). However, which patients can be safely observed at a non-PTC is not directly addressed. Methods A systematic review of the literature was conducted, focusing on management of pediatric TBI and transfer decisions from 1990 to 2020. Results Pediatric TBI patients make up a great majority of preventable transfers and admissions, and comprise a significant portion of avoidable costs to the health care system. Majority of mild TBI patients admitted to a PTC following transfer do not require ICU care, surgical intervention, or additional imaging. Studies have shown that as high as 83% of mild pediatric TBI patients are discharged within 24 hrs. Conclusions An evidence-based clinical practice algorithm was derived through synthesis of the data reviewed to guide transfer decision. The papers discussed in our systematic review largely concluded that transfer and admission was unnecessary and costly in pediatric patients with mild TBI who met the following criteria: blunt, no concern for NAT, low risk on PECARN assessment, or intermediate risk on PECARN with negative imaging or imaging with either isolated, nondisplaced skull fractures without ICH and/or EDH, or SDH <0.3 cm with no midline shift.

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Effects of Pediatric Traumatic Brain Injury on Verbal IQ: A Systematic Review and Meta-Analysis

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721001296 ◽

2021 ◽

pp. 1-13

Author(s):

Carly A. Cermak ◽

Shannon E. Scratch ◽

Nick P. Reed ◽

Lisa Kakonge ◽

Deryk S. Beal

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Meta Analysis ◽

Small Sample ◽

Extensive Literature ◽

Pediatric Traumatic Brain Injury ◽

Mild Tbi ◽

Verbal Iq ◽

Statistical Heterogeneity

Abstract Objectives: To examine the effects of pediatric traumatic brain injury (TBI) on verbal IQ by severity and over time. Methods: A systematic review and subsequent meta-analysis of verbal IQ by TBI severity were conducted using a random effects model. Subgroup analysis included two epochs of time (e.g., <12 months postinjury and ≥12 months postinjury). Results: Nineteen articles met inclusion criteria after an extensive literature search in MEDLINE, PsycInfo, Embase, and CINAHL. Meta-analysis revealed negative effects of injury across severities for verbal IQ and at both time epochs except for mild TBI < 12 months postinjury. Statistical heterogeneity (i.e., between-study variability) stemmed from studies with inconsistent classification of mild TBI, small sample sizes, and in studies of mixed TBI severities, although not significant. Risk of bias on estimated effects was generally low (k = 15) except for studies with confounding bias (e.g., lack of group matching by socio-demographics; k = 2) and measurement bias (e.g., outdated measure at time of original study, translated measure; k = 2). Conclusions: Children with TBI demonstrate long-term impairment in verbal IQ, regardless of severity. Future studies are encouraged to include scores from subtests within verbal IQ (e.g., vocabulary, similarities, comprehension) in addition to functional language measures (e.g., narrative discourse, reading comprehension, verbal reasoning) to elucidate higher-level language difficulties experienced in this population.

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