Cerebrovascular pathophysiology in pediatric traumatic brain injury
Cerebrovascular pathophysiology in pediatric traumatic brain injury
Background: traumatic brain injury (TBI) is the leading cause of traumatic morbidity and mortality in children. Although there is increasing information concerning TBI in adults and experimental animal models, relatively little is known regarding cerebrovascular pathophysiology specific to children.
Materials: a review of the pertinent medical literature.
Results: systemic and cerebral hemodynamic factors such as hypotension, hypoxia, hyperglycemia, and fever are associated with poor outcome in pediatric TBI. Similarly, cerebral autoregulation is often impaired after TBI and may adversely affect outcome, especially if systemic hemodynamics are altered. Furthermore, CO2 vasoreactivity may be altered after pediatric TBI and lead to either cerebral ischemia or hyperemia.
Conclusions: understanding the effect of pediatric TBI on the cerebral circulation is needed to potentially develop protocols to improve outcome in this vulnerable population. Specifically, changes in pediatric cerebrovascular physiology and pathophysiology, including CO2 vasoreactivity and pressure autoregulation, must be understood and their mechanism elucidated.
S128-34
Philip, Shaji
1c466ab2-6902-45c4-9b25-4f1a2430770f
Udomphorn, Yuthana
09607156-9282-4647-b625-77c12c7ea16c
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Vavilala, Monica S.
b415712f-3409-4a76-b47b-b62ba2fd3d00
August 2009
Philip, Shaji
1c466ab2-6902-45c4-9b25-4f1a2430770f
Udomphorn, Yuthana
09607156-9282-4647-b625-77c12c7ea16c
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Vavilala, Monica S.
b415712f-3409-4a76-b47b-b62ba2fd3d00
Philip, Shaji, Udomphorn, Yuthana, Kirkham, Fenella J. and Vavilala, Monica S.
(2009)
Cerebrovascular pathophysiology in pediatric traumatic brain injury.
The Journal of Trauma, 67 (2 Suppl), .
(doi:10.1097/TA.0b013e3181ad32c7).
Abstract
Background: traumatic brain injury (TBI) is the leading cause of traumatic morbidity and mortality in children. Although there is increasing information concerning TBI in adults and experimental animal models, relatively little is known regarding cerebrovascular pathophysiology specific to children.
Materials: a review of the pertinent medical literature.
Results: systemic and cerebral hemodynamic factors such as hypotension, hypoxia, hyperglycemia, and fever are associated with poor outcome in pediatric TBI. Similarly, cerebral autoregulation is often impaired after TBI and may adversely affect outcome, especially if systemic hemodynamics are altered. Furthermore, CO2 vasoreactivity may be altered after pediatric TBI and lead to either cerebral ischemia or hyperemia.
Conclusions: understanding the effect of pediatric TBI on the cerebral circulation is needed to potentially develop protocols to improve outcome in this vulnerable population. Specifically, changes in pediatric cerebrovascular physiology and pathophysiology, including CO2 vasoreactivity and pressure autoregulation, must be understood and their mechanism elucidated.
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Published date: August 2009
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Local EPrints ID: 146871
URI: http://eprints.soton.ac.uk/id/eprint/146871
ISSN: 0022-5282
PURE UUID: 03e09c4d-db38-4761-977a-d9ab6e4e8ae8
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Date deposited: 29 Apr 2010 13:55
Last modified: 14 Mar 2024 02:45
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Author:
Shaji Philip
Author:
Yuthana Udomphorn
Author:
Monica S. Vavilala
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