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Pointillart V, Petitjean ME, Wiart L, et al Pharmacological therapy of spinal cord injury during the acute phase Spinal Cord 2000;38:71–76 Prendergast MR, Saxe JM, Ledgerwood AM, et al Massive steroids not reduce the zone of injury after penetrating spinal cord injury J Trauma 1994;37:576– 579; discussion 579–580 Qian T, Campagnolo D, Kirshblum S High-dose methylprednisolone may more harm for spinal cord injury Med Hypotheses 2000;55(5):452–453 Ralston ME Physiologic anterior subluxation: case report of occurrence at C5 to C6 and C6 to C7 spinal levels Ann Emerg Med 2004;44:472–475 Richter D, Latta LL, Milne EL, et al The stabilizing effects of different orthoses in the intact and unstable upper cervical spine: a cadaver study J Trauma 2001;50:848–854 Rozzelle CJ, Aarabi B, Dhall SS, et al Management of pediatric cervical spine and spinal cord injuries Neurosurgery 2013;72:205–226 Schellinger PD, Schwab S, Krieger D, et al Masking of vertebral artery dissection by severe trauma to the cervical spine Spine (Phila Pa 1976) 2001;26:314–319 Short DJ, El Masry WS, Jones PW High dose methylprednisolone in the management of acute spinal cord injury—a systematic review from a clinical perspective Spinal Cord 2000;38(5):273–286 Skellett S, Tibby SM, Durward A, et al Lesson of the week: immobilisation of the cervical spine in children BMJ 2002;324:591–593 Slaar A, Fockens M, Wang J, et al Triage tools for detecting cervical spine injury in pediatric trauma patients Cochrane Database Syst Rev 2017;12:CD011686 Sumchai A, Sternbach G Hangman’s fracture in a 7-week-old infant Ann Emerg Med 1991;20:86–89 Sun PP, Poffenbarger GJ, Durham S, et al Spectrum of occipitoatlantoaxial injury in young children J Neurosurg 2000;93:28–39 Swischuk LE Imaging of the Cervical Spine in Children New York: SpringerVerlag; 2002 Tat S, Mejia M, Freishtat R Imaging, clearance, and controversies in pediatric cervical spine trauma Pediatr Emerg Care 2014;30(12):911–915 Tescher AN, Rindflesch AB, Youdas JW, et al Range-of-motion restriction and craniofacial tissue-interface pressure from four cervical collars J Trauma 2007;63:1120–1126 Vickery D The use of the spinal board after the pre-hospital phase of trauma management Emerg Med J 2001;18:51–54 Vohra S, Johnston BC, Cramer K, et al Adverse events associated with pediatric spinal manipulation: a systematic review Pediatrics 2007;119:e275–e283 Woodward GA, Kunkel CN Cervical spine immobilization and imaging In: King C, Henretig FM, eds Textbook of Pediatric Emergency Procedures 2nd ed Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins; 2008:313– 323 Zhang S, Michael M, Clowers K, et al Evaluation of efficacy and 3D kinematic characteristics of cervical orthoses Clin Biomech (Bristol, Avon) 2005;20:264– 269 CHAPTER 113 ■ NEUROTRAUMA JULIE McMANEMY, ANDREW JEA, KATRINA DUCIS GOALS OF EMERGENCY THERAPY Head injury is a common presentation in the pediatric emergency department (ED) The challenge is to distinguish minor head trauma from clinically important traumatic brain injury (ciTBI) Identifying which children necessitate radiographic imaging and immediate recognition of ciTBI should be the goal of the evaluation Management of the head injured child should focus on stabilization, recognition of clinical deterioration, and early consultation of a neurosurgeon to decrease morbidity and mortality KEY POINTS Headache is a common presenting symptom Most head injuries are minor and not necessitate clinical interventions Infants with intracranial injuries may appear to be asymptomatic due to limitations in their neurologic examination The most common cause of mortality from child abuse is head trauma Cervical spine injury in children is rare, but occurs with traumatic brain injury (TBI) in 20% of patients RELATED CHAPTERS Signs and Symptoms Injury: Head: Chapter 41 Pain: Headache: Chapter 59 Vomiting: Chapter 81 Medical, Surgical, and Trauma Emergencies A General Approach to the Ill or Injured Child: Chapter Neurosurgical Emergencies: Chapter 122 Child Abuse/Assault: Chapter 87 The Children’s Hospital of Philadelphia Clinical Pathways ED Pathway for Evaluation/Treatment of Children With Sexual Abuse Concerns URL: https://www.chop.edu/clinical-pathway/abuse-suspectedsexual-or-sexual-assault-clinical-pathway Authors: J Lavelle, MD; J Molnar, MSN, PNP-BC; C Christian, MD; S Frioux, MD; P Scribano, DO Posted: May 2018, last revised October 2018 ED Pathway for Evaluation and Treatment of Acute Head Trauma URL: https://www.chop.edu/clinical-pathway/head-trauma-acuteclinical-pathway Authors: M Zonfrillo, MD; F Nadel, MD; D Corwin, MD; M Mittal, MD; C Jacobstein, MD; J Lavelle, MD; P Scribano, DO Posted: December 2010, last revised July 2019 NEUROTRAUMA Blunt Head Injury CLINICAL PEARLS AND PITFALLS ... NEUROTRAUMA JULIE McMANEMY, ANDREW JEA, KATRINA DUCIS GOALS OF EMERGENCY THERAPY Head injury is a common presentation in the pediatric emergency department (ED) The challenge is to distinguish minor... Kunkel CN Cervical spine immobilization and imaging In: King C, Henretig FM, eds Textbook of Pediatric Emergency Procedures 2nd ed Baltimore, MD: Wolters Kluwer/Lippincott Williams & Wilkins; 2008:313–

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