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Child's Nervous System

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01-02-2020 | Central Nervous System Trauma | Review Article

Posttraumatic cerebrovascular injuries in children. A systematic review

Authors: Nader Hejrati, Florian Ebel, Raphael Guzman, Jehuda Soleman

Published in: Child's Nervous System | Issue 2/2020

Abstract

Introduction

Posttraumatic craniocervical vascular injuries in pediatric traumatic brain injury (TBI) are rare, and children-specific, evidence-based standards on screening and therapy of posttraumatic carotid-cavernous fistula (CCF), craniocervical artery dissections (CCAD), traumatic aneurysms (TA), and posttraumatic sinus venous thrombosis (SVT) is lacking. The aim of this review is to summarize the data on epidemiology, clinical presentation, and treatment of these traumatic lesions in a systematic manner.

Methods

We performed a systematic PubMed search for records of CCF, CCAD, TA, and SVT related to pediatric TBI published until June 2019.

Results

After screening 2439 records, 42 were included in the quantitative analysis. Incidences for CCAD in blunt TBI were 0.21% (range 0.02–6.82%). 11.7% (range 1.69–15.58%) of pediatric aneurysms were found to be traumatic of origin, whereas 38.2% (range 36.84–40%) of all pediatric SVT were due to blunt TBI. For all of the posttraumatic cerebrovascular pathologies, we found a clear male predominance with 68.75% in CCF, 63.4% in CCAD, 60% in TA, and 58.33% in SVT. Clinical presentation did not differ from the adult population with exception of young child. While there is only recommendation for the therapy of CCAD and SVT in the pediatric population, no such recommendation exists for the treatment of CCF’s and TA’s, and data from randomized controlled trials is lacking.

Conclusion

While these results show that posttraumatic CCF, CCAD, TA, and SVT are rarely encountered in children, misdiagnosis may have potentially drastic consequences due to a longer lifetime burden in the pediatric population. Awareness, early recognition, and prompt initiation of the appropriate therapy are essential to avoid morbidity and mortality. Further studies should focus on the development of clinical and radiological screening criteria of posttraumatic vascular lesions in children.

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Title: Posttraumatic cerebrovascular injuries in children. A systematic review
Authors: Nader Hejrati
Florian Ebel
Raphael Guzman
Jehuda Soleman
Publication date: 01-02-2020
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Venous Thrombosis
Aneurysm
Aneurysm
Venous Thrombosis
Skull Fracture
Published in: Child's Nervous System / Issue 2/2020
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-019-04482-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Posttraumatic cerebrovascular injuries in children. A systematic review

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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