Project details

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Pediatric Traumatic brain injury: detection, monitoring and long term prognosis

Keywords:
children traumatic brain injury biomarkers

Researchers:
J. van der Naalt
Dr. H.J. van der Horn
Jelte Helfferig

Type of project:
Pilot project (year 2 or 3) of Stage Wetenschap / Researchproject

Nature of the research:
Clinical and/or epidemiological research

Fields of study:
neurology radiology intensive care

Background / introduction
Traumatic brain injury (TBI) is one of the most frequent causes of morbidity and mortality. Each year, 12,000 children with TBI are seen at Emergency Departments (ED) throughout the Netherlands, most commonly with mild TBI. One in four patients has residual impairments that interfere with resumption of daily activities and school. To develop appropriate care for these patients, it is important to assess factors that are related to incomplete recovery. Furthermore, it is important to study the epidemiology and potential causes of TBI, to identify potential options for prevention.
The UMCG is a level-1 Trauma Center at which 150 children with TBI aged 1-18 years are admitted to the ED annually . Neurotraumatology is one of the research topics of the Department of Neurology with focus on follow-up to determine factors that are related to outcome. Areas of interest concern imaging of brain injury in clinical practice, the epidemiological aspects of TBI such as the consequences of e-bike use in children and sport injuries, monitoring at the ICU and the pediatric ward, and the juvenile head trauma syndrome. Research is done in collaboration with the Department of Pediatrics, Radiology, Rehabilitation Medicine, Clinical Neurophysiology and Neuropsychology. There are various possibilities for regional collaboration.
Research question / problem definition
1. To assess factors (injury related, genetics), that are related to recovery (outcome and persistent complaints) in pediatric TBI
2. To determine the additive value of different types of monitoring (e.g., imaging, neurophysiology, clinical) for treatment policies and prognosis in children with TBI.
3. To establish/examine/determine the role of social and emotional vulnerability of children for persistent complaints after TBI.
4. Unraveling the pathophysiology of the Juvenile Head trauma syndrome with several biomarkers
5. To explore the changes in epidemiology regarding the increased use of e-bikes in children
Workplan
the student will participate in one of the related topics of ongoing research and will be involved in several aspects of research (data collection, analysis of results and if possible the writing of a manuscript for publication). Depending on the scope of a project, broadening to development of a MD-PhD project is possible. During the research project, the student is part of the Neurotrauma Research Group and will participate in ongoing meetings and can participate in the outpatient clinical follow-up.
References
• Mulder HD, Helfferich J, Kneyber MCJ. The neurological wake-up test in severe pediatric traumatic brain injury: a long term, single-center experience. Front Pediatr. 2024 Feb 23;12:1367337. doi: 10.3389/fped.2024.1367337. PMID: 38464893; PMCID: PMC10920253.
• DA Chung, Lenstra JJ, Metting Z, Rakers SE, Spikman JM, Elting JWJ, van der Naalt J. The feasibility of fNIRS as a diagnostic tool for pediatric TBI: A pilot study. Eur J Paediatr Neurol. 2021 Jan;30:22-24. doi: 10.1016/j.ejpn.2020.12.008. Epub 2020 Dec 27. PMID: 33378734.
• Lenstra JJ, Pikstra ARA, Fock JM, Metting Z, van der Naalt J. Influence of guidelines on management of paediatric mild traumatic brain injury: CT-assessment and admission policy. Eur J Paediatr Neurol. 2017 Nov;21(6):816-822. doi: 10.1016/j.ejpn.2017.07.019. Epub 2017 Aug 3. PMID: 28811137.
• Pikstra ARA, Metting Z, Fock JM, van der Naalt J. The juvenile head trauma syndrome - Deterioration after mild TBI: Diagnosis and clinical presentation at the Emergency Department. Eur J Paediatr Neurol. 2017 Mar;21(2):344-349. doi: 10.1016/j.ejpn.2016.09.005. Epub 2016 Sep 23. PMID: 27707655
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