Management of head injury in children

OBJECTIVE: To make pediatricians aware of ideas about how to handle head injury in children under and over 2 years of age, to facilitate understanding and to allow a rethinking about the necessary care when attending children with head injury. SOURCES: A bibliographic review of the theme based on Medline. SUMMARY OF THE FINDINGS: The following aspects were analyzed: the overall epidemiological aspects, the concept and the physiopathology of the damage caused by brain trauma. The assessment of the severity of head injury for different age ranges was discussed, as well as the opinion of various authors and the current ideas about the criteria regarding hospitalization, request for supplementary exams and therapeutic approach. The value of neuroimaging exams in cases of head injury and, finally, the prevention strategies and conclusions also were discussed. CONCLUSIONS: In most cases, head injuries in children are rated as not being severe. Nevertheless, even though they are seen as slight, when considering the pediatric population the clinical picture is often asymptomatic presenting neuroimaging changes, the management of head injury at this age range is different from the management in adults.