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Self-Assessment Questions

Critical Care Medicine

Traumatic Brain Injury in Children: Review Questions

Joseph Varon, MD, FACP, FCCP, FCCM, and Paul E. Marik, MD, FCCP, FCCM

Dr. Varon is a professor, acute and continuing care, University of Texas Health Science Center, Houston, TX.
Dr. Marik is professor of critical care medicine, University of Pittsburgh, Pittsburgh, PA.

Choose the single best answer for each question.

1. Which one of the following statements regarding the epidemiology of traumatic brain injury (TBI) in the United States is correct?
  1. There are more than 2 million head injuries every year in the United States
  2. Fewer than 100,000 patients with TBI are admitted to the hospital each year in the United States
  3. Pediatric TBI survival is better than that of similarly injured adults
  4. 75,000 children die or become permanently disabled because of head injuries every year in the United States
  5. Head injuries are the leading cause of death and disability in children and adolescents
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2. Which of the following factors has the greatest predictive value in the development of seizures following head trauma?

  1. Patient age
  2. Occipital lobe injury
  3. Concomitant use of illicit drugs
  4. Glasgow coma score (GCS) < 8
  5. Generalized brain injury
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3. Which one of the following statements regarding hyperventilation using assisted ventilation (Paco2 < 25 mm Hg) in the setting of TBI in children is correct?
  1. It has no significant role except in certain patients who are deteriorating rapidly
  2. It should be used in all children regardless of the presence of elevated intracranial pressure (ICP)
  3. It is effective for several days after the initial injury occurs
  4. It produces cerebral vasodilatation
  5. It is associated with an improved neurologic outcome when compared with patients who are kept normocapnic
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4. All of the following measures can be used in attempting to control elevated ICP in children with TBI EXCEPT:

  1. Elevate the head of the bed to 30 degrees
  2. Administration of mannitol
  3. Pentobarbital
  4. Therapeutic hyperthermia (core temperature > 38.5°C)
  5. Ventriculostomy with cerebrospinal fluid removal
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