Increasingly we are seeing children in the days to weeks following traumatic brain injuries in the Pediatric Emergency Department. Most often these children present with persistent headaches. After a discussion with he family about how neuroimaging is unlikely to benefit the majority of patients it is time to discuss treatment considerations.*
*Side Note: In my experience it is more common than you’d think to see a patient for the first time in the ED several days after the TBI – during this initial visit parents are still invariably worried about intracranial hemorrhage or other life threatening concerns. Discuss the literature with them as warranted.
What follows is a quick hit style discussion of a potential treatment plan.