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Arch Dis Child. 2007 June; 92(6): 563.
PMCID: PMC2066163

Management of brain injured children, 2nd edition

Reviewed by Neil Harrower

Edited by Richard Appleton, Tony Baldwin. Published by Oxford University Press, Oxford, 2006, pp 398, £32.95 (paperback). ISBN 0-198-56724-3

The concept of multi‐disciplinary working in child health is frequently paid lip‐service by professionals but is less frequently achieved in practice. This important book on the management of brain injured children is a truly multi‐disciplinary production from the head injury rehabilitation team led by Richard Appleton at Alder Hey, Liverpool. The book is now in its second edition; the first edition, published in 1998, has been revised to provide a comprehensive guide for professionals managing brain injured children. New information on long‐term effects of acquired brain injury (ABI) and resuscitation advances has been included.

The 15 contributors cover acute treatment of brain injury, through nursing and therapy needs to the assessment of cognitive problems and re‐integration into the home and educational environments. There is an excellent personal contribution by a survivor of ABI and her mother, which gives some insight into the effect on individuals and their families.

Advances in the management of children with ABI have meant improved survival rates but consequently higher morbidity in survivors, ranging from transient memory deficits to complex, multiple difficulties.

The book discusses the issues around giving long‐term prognostic information to families following ABI and highlights problems such as the “sleeper effect”, where an individual who has apparently made a good recovery presents years later with cognitive difficulties or school failure.

The book is well‐referenced with good quality neuro‐imaging examples, but it could have benefited from more diagrams, particularly to help explain the chapter on cognitive assessment, and the images in the feeding assessment chapter are of disappointing quality.

ABI is an important subject – the average district general hospital can expect to see 10 children each year who will need rehabilitation – and this book is an excellent guide for the paediatrician and other professionals in the team. It deserves to be widely read.read.

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