Abstract
Radiological assessment of the head is a routine part of the management of traumatic brain injury. This assessment can help to determine the requirement for invasive intracranial pressure (ICP) monitoring. The radiological correlates of elevated ICP have been widely studied in adults but far fewer specific pediatric studies have been conducted. There is, however, growing evidence that there are important differences in the radiological presentations of elevated ICP between children and adults; a reflection of the anatomical and physiological differences, as well as a difference in the pathophysiology of brain injury in children. Here in, we review the radiological parameters that correspond with increased ICP in children that have been described in the literature. We then describe the future directions of this work and our recommendations in order to develop non-invasive and radiological markers of raised ICP in children.
Highlights
Traumatic brain injury (TBI) in children remains a UK and worldwide public health concern
We describe the future directions of this work and our recommendations in order to develop non-invasive and radiological markers of raised intracranial pressure (ICP) in children
The imaging modalities that have been tested against ICP are computed tomography (CT), magnetic resonance imaging (MRI), and ultrasonography (US)
Summary
Traumatic brain injury (TBI) in children remains a UK and worldwide public health concern. In the global context of neurosurgery, a requirement for the expertise to insert such a device can result in delays in the implementation of guided medical therapy: some areas of the world are served by 1 neurosurgeon per 9 million patients (compared with the 1 per 80,000 in developed countries) [6]. These issues have been brought to the fore by the results of a recent randomized-control trial in adults, which questioned the ostensible positive effect that invasive monitoring has on outcomes, stimulating debate as to whether invasive monitoring is over-utilized in current practice [7]. We describe the future directions of this work and our recommendations in order to develop non-invasive and radiological markers of raised ICP in children
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