Traumatic brain injuries in pediatrics are among the most common causes of pediatric emergency room visits and is usually associated with long-term disability and neurological sequelae []. Despite advances in prevention, diagnosis and management of traumatic brain injuries, the mortality and morbidity rates are high among pediatric population []. The epidemiological studies have revealed that alls, motor vehicle accidents and recreational activities are the most common causes of traumatic brain injuries in pediatrics [,]. Greatest hits of the 80's. The management of moderate to severe traumatic brain injuries include prolonged intensive care and rehabilitation although the prognosis and the outcome remains elusive. Thus, several scoring systems have been introduced and validated in order to determine the outcome of the pediatric patients with traumatic brain injuries []. Several factors have been reported to be related to the patient outcome including age, the duration of the coma, the type of the brain lesion, the pattern of the pupils, injury severity score, the motor patterns, impaired reflexes of the brain stem, hypotension, hypoxia and the Glasgow Coma Scale (GCS) [].

Read the latest articles of Journal of Pediatric Surgery at ScienceDirect.com, Elsevier's leading platform of. Pages 1-9: Download PDF. Pediatric trauma patients with isolated airway compromise or Glasgow Coma Scale less than 8: does immediate attending surgeon's presence upon arrival make a difference? Glasgow Paediatric Coma Score The Paediatric GCS is scored between 3 and 15, 3 being the worst, and 15 the best. It is composed of three parameters: Best Eye Response, Best Verbal Response, Best Motor Response, as given below: Best Eye Response. The Pediatric Glasgow Coma Scale (PGCS) assesses the mental state of child patients.

Some laboratory and paraclinical investigations have also been used to predict the outcome including brainstem auditory evoked potentials and cognitive event-related potentials []. For instance, it has been shown that event-related potentials such as N400 could be reliably used to predict the post-traumatic language skills (subcortical and cortical systems) in those with severe traumatic brain injury suffering from aphasia [].

Several lines of evidence suggest that pediatric patients suffering from severe traumatic brain injury have better prognosis when compared to adults []. In other words, the recovery of pediatric patients with traumatic brain injury is significantly better than adults []. In addition, it has been demonstrated that younger children have better outcome compared to older ones [].

The later fact, however, is a controversial issue while some studies have shown that younger children have worst prognosis after traumatic brain injuries []. Younger children have incomplete myelinization which makes them more susceptible to shearing injury []. It was shown that pediatric patients older than 6 years have better motor and cognitive function after traumatic brain injury [].