When does the neurological system develop in utero?
By the 4th week 🗓
What happens to the skull as kids age?
• Skull thickens
• Decreased pliability
• Fontanelles fuse AFTER brain growth slows
When does the most myelination occur in children?
First 3 years of life
What is Craniostenosis? 🔲
Premature closure of sutures
- 📈 ICP and malformation
Tx: surgery before 6M with helmet
What is Deformational Plagiocephaly? 🥥
Asymmetry & flattening of skull
- found with back-sleeping
Tx: repositioning and orthotic use
What is Microcephaly? ▫️
Abnormally small head
- cognitive impairments and head circumference <2 standard deviations below average
Tx: supportive care
What is Hydrocephalus 💧
Collection of CSF in the brain
- causes: ⬆️ production of CSF, ⬇️ CSF absorption, Outflow obstruction
S/S: bulging veins, bulging fontanelle, sunsetting eyes, high-pitched shrill cry
Tx: VP shunt (monitor head circumference and replace with growth spurts)
What is Meningitis?
Infection of meninges
- Viral 🔵 or Bacterial 🟢 (strep)
S/s: fever, headache, photophobia, petichiae
⚠️ Prophylactic ABX
Diagnosed with Lumbar Puncture
What is Reye’s Syndrome?
Organ failure from aspirin use in young children with viral illnesses 🔵
- mitochondrial injury releases cytotoxin
Tx: steroids, diuretics
What is Encephalitis?
Infection of brain tissue from virus, bacteria, auto-immune or fungi
- diagnosed w| CT, MRI, & Labs 🔬
Tx: Antibiotics, antiviral, or steroids
What are seizures?
Electrical disturbances in the brain ⚡️🧠
Focal vs. Generalized seizures
Focal: one side of the brain
Generalized: both sides of the brain
Types of seizures:
Absent: vacant unresponsive stare
Myoclonic: sudden forceful contractions
Clonic: rhythmic jerking
Tonic-clonic: contractions on and off, loss of consciousness
Atonic: drop attacks
What is epilepsy?
Recurrent seizures
- 2+ unprovoked seizures more than 24 hrs apart, or 1 seizure with chance of recurring in 10 years
What are the ABC’s for seizures?
Airway Breathing Circulation
Don’t Ever Forget Glucose!
Describe the Keto diet 🥗
LOW carb high fat diet
- reduces seizures in chronic patients
What are Febrile Seizures?
Seizures triggered by body temp of 102⁰+ in kids 7 or under 🤒
Early vs. Late signs of head trauma
Early: N/V, headache, poor feeding
Late: posturing, nonresponsive pupils, seizures, primitive reflexes return
Signs of ICP 📈
Infants: bulging fontanelle, high-pitched shrill cry, poor feeding, sunsetting eyes
Child: n/v, headache, blurred vision, unresponsiveness
