Foreword

Article Outline

• Copyright

Jack and Jill went up the hill

To fetch a pail of water,

Jack fell down and broke his crown,

And Jill came tumbling after.

Up Jack got and home he ran

As fast as he could caper.

There his mother bound his head

With vinegar and brown paper.

This well-known nursery rhyme which dates back hundreds of years illustrates that pediatric head trauma and its treatment have long been subjects of concern in our society. (For all you nursery rhyme history buffs out there, the origins of this rhyme are unclear and the original subjects may not have been children, but that is certainly how the rhyme has evolved). In this month’s issue, Dr. Naomi Bishop provides us with a wide-ranging review of traumatic brain injury (TBI) in children, from the biochemical mechanisms of injury to the epidemiology and clinical management. Dr. Bishop describes the recent establishment of expert guidelines for the management of TBI, making it clear that therapies have advanced well beyond the vinegar and brown paper stage. However, Dr. Bishop’s careful review of the evidence also emphasizes that much remains to be done in order to fully understand the mechanisms of brain injury, and to establish the best possible therapies for pediatric patients with head trauma.