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A recent major change in thinking states that early childhood TBI may result in a severe compromise of normal brain growth and development such that TBI, rather, may compromise later normal development resulting in a need for very long term patient care and management. The mechanisms of injury and pathology within the injured brain are reviewed and compared between when injury occurs at or close to the time of birth, in an infant, in a young child, in a child between ages 5 and 10, in young and older adolescents and in young adulthood. Our understanding of pathophysiological responses by cells of the human central nervous system has recently greatly increased but has really only served to illustrate the great complexity of interactions between different types of cell within the growing and developing CNS. The hypothesis is developed that the outcome for a very young patient differs with the relative state of development of injured cells at the locus of injury. And that the potential for either repair, re\u2010instatement of normal cellular and organ function or for continued normal development is much reduced after an early brain insult (EBI) compared with TBI in a slightly older child or young adult patient. The advent of increasingly sophisticated non\u2010invasive imaging technology has allowed assessment of the influence and time course of brain pathology both early and late after TBI. This has generated greater confidence on the part of clinicians in forecasting outcomes for an injured patient. But our increased understanding has still not allowed development of therapeutic strategies that might ameliorate the effect of an injury. It is suggested that an improved integration of major clinical and scientific effort needs to be made to appreciate the import of multiple interactions between cells forming the neurovascular unit in order to improve any potential for post\u2010traumatic recovery after TBI in neonates and young children.<\/jats:p>","DOI":"10.1016\/j.ijdevneu.2011.12.008","type":"journal-article","created":{"date-parts":[[2011,12,27]],"date-time":"2011-12-27T10:54:33Z","timestamp":1324983273000},"page":"167-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Traumatic brain injury in the neonate, child and adolescent human: An overview of pathology"],"prefix":"10.1002","volume":"30","author":[{"given":"William L.","family":"Maxwell","sequence":"first","affiliation":[{"name":"Anatomy, Thomson Building School of Medicine Veterinary Medicine and Life Sciences University of Glasgow Glasgow G12 8QQ Scotland United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,12,26]]},"reference":[{"key":"e_1_2_6_1_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1989.tb03040.x"},{"key":"e_1_2_6_1_3_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-4159.2000.741951000000000.x"},{"key":"e_1_2_6_1_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awn293"},{"key":"e_1_2_6_1_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awr103"},{"key":"e_1_2_6_1_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhp282"},{"key":"e_1_2_6_1_7_1","unstructured":"G.Ball J.P.Boardman D.Rueckert P.Aljabar T.Arichi N.Merchant I.S.Gousias A.D.Edwards S.J.Counsell.The effect of preterm birth on thalamic and cortical development.Cereb. 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