Management of Paediatric Traumatic Brain Injury: A Comprehensive Review of Current Evidence and Emerging Strategies

Paediatric Traumatic Brain Injury (TBI) is a significant health concern, contributing to morbidity and mortality. Epidemiology shows variations influenced by demographics, age and injury severity. Status Epilepticus (SE) is a common complication of seizure activity, negatively affecting clinical outcomes. Secondary TBI increases neuronal damage, underscoring the necessity of effectively managing Intracranial Pressure (ICP) and Cerebral Perfusion Pressure (CPP). Assessing strategies such as direct ICP measurement and brain tissue oxygen monitoring is pivotal for informing interventions. Pharmacological agents, including osmotic therapies and antiepileptic medications, are crucial for managing TBI symptoms and preventing complications. Temperature monitoring is essential for reducing metabolic demand. Individuals surviving severe TBI (sTBI) face functional disabilities, cognitive impairments and mental health issues, impacting their quality of life. Despite diagnostic advancements, the pathophysiology and optimal management of paediatric TBI remain controversial. Nevertheless, global perspectives exist to enhance knowledge and optimise clinical management guidelines to improve outcomes. The present study aimed to provide a comprehensive review of the epidemiology, pathophysiology and management strategies for paediatric TBI, emphasising current approaches and emerging modalities.