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Changes in brain growth and connectivity continue throughout an individual's lifespan. The most rapid period of cerebral changes are observed during infancy and childhood but have recently been shown to continue into early adulthood (Toga et al.,2006). While the pediatric population as a whole shows robust differences across countless variables compared to the “adult” or mature brain, there are also significant differences between subgroups within the pediatric population. The pediatric population is not a homogenous group, but rather is made up of subgroups as defined by their developmental profiles for a given parameter. Despite the fact that increasing clinical and experimental evidence reveals age-related differences in response to traumatic brain injury (TBI) within the pediatric population, there remains a lack of appreciation for these differences when establishing standards of care for children. Many parameters (serum glucose management) continue to be “modified” from adult practice without direct knowledge of age-related responses. These findings emphasize the fact that developmental physiology impacts the pathophysiological response to traumatic brain injury and ultimately influences developmental disability.
Traumatic brain injury early in life
Myelination and compliance
Changes in cerebral myelination continue throughout adolescence into early adulthood (Courhesne et al., 2000; Giorgio et al., 2008; Paus et al., 1999). As brain myelin content increases, brain water content decreases (Himwich, 1973) with consequent changes in the biomechanical properties of the brain.
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