Post-traumatic encephalopathy (PTE) in children is a multifactorial pathological condition that develops following traumatic brain injury and is characterized by both acute and long-term disturbances of central nervous system function. Its pathogenesis is driven by the interaction between primary mechanical damage and a cascade of secondary neurobiological processes, including excitotoxicity, mitochondrial dysfunction, ionic imbalance, oxidative stress, blood–brain barrier disruption, and neuroinflammation. Age-related features of the developing brain—such as incomplete myelination, high metabolic demand, and enhanced neuroplasticity—determine both increased vulnerability to traumatic injury and potential for recovery. Long-term consequences of pediatric PTE may manifest as cognitive, behavioral, and emotional impairments that negatively affect quality of life and neuropsychological development. A deeper understanding of the underlying pathophysiological mechanisms is essential for improving diagnostic approaches, prevention, and the development of effective neuroprotective strategies in pediatric neurology.

Post-traumatic encephalopathy; Traumatic brain injury; Pediatric neurology; Neuroinflammation; Excitotoxicity; Mitochondrial dysfunction; Blood–brain barrier; Cognitive impairment.

Makarova E.V., Grinenko O.A. Post-traumatic cognitive impairments in children. Pediatriya. 2020;99(5):65–70.

World Health Organization. Global status report on road safety. Geneva: WHO; 2018.

Giza C.C., Prins M.L. Is being plastic fantastic? Mechanisms of altered plasticity after developmental traumatic brain injury. Neuropharmacology. 2022;195:108700.

Semple B.D. et al. Brain development in children after TBI. Brain. 2017;140:2929–2945.

Rogers J.M., Read C.A. Psychiatric and neuropsychological sequelae of pediatric TBI. Child Neuropsychology. 2020;26(1):1–26.

Lozano D. et al. Neuroinflammatory responses to traumatic brain injury in the immature brain. J Neuroinflammation. 2019;16:40.

Henry R.J., Ritzel R.M., Barrett J.P. Microglial priming in pediatric traumatic brain injury. Brain Behav Immun. 2021;92:1–14.

Babikian T., Asarnow R. Neurocognitive outcomes of pediatric TBI. Curr Opin Neurol. 2020;33(6):696–702.

KarpoV S.M. Pediatric traumatic brain injury: modern aspects of diagnosis and treatment. Detskaya Meditsina. 2019;10(3):12–18.

Scafidi J. et al. Metabolic injury during neonatal brain development. Pediatr Res. 2018;83:102–109.

Kochanek P.M. et al. Emerging therapies in traumatic brain injury. JAMA Pediatrics. 2023;177(3):239–247.

Semple B.D. et al. Brain development in children after TBI. Brain. 2017;140:2929–2945.

Karpov S.M. Pediatric traumatic brain injury. Detskaya Meditsina. 2019;10(3):12–18.

Kochanek P.M. et al. Pediatric traumatic brain injury: mechanisms of injury. JAMA Pediatrics. 2023;177(3):239–247.

Giza C.C., Prins M.L. Mechanisms of altered plasticity after pediatric TBI. Neuropharmacology. 2022;195:108700.

Makarova E.V. Post-traumatic neuronal damage. Pediatriya. 2020;99(5):65–70.

Werner C., Engelhard K. Pathophysiology of TBI. Br J Anaesth. 2007;99:4–9.

Ikonomidou C. Excitotoxicity and brain development. Lancet Neurol. 2019;18(3):282–292.

Scafidi J. et al. Mitochondrial injury in immature brain. Pediatr Res. 2018;83:102–109.

Hall E.D. Oxidative damage in TBI. J Neurotrauma. 2017;34:1–12.

Xiong Y., Mahmood A. Ionic imbalance after TBI. Neuroscience. 2021;452:154–167.

Shlosberg D. et al. BBB breakdown as a therapeutic target. Nat Rev Neurol. 2018;14:237–250.

Lozano D. et al. Neuroinflammatory responses in pediatric TBI. J Neuroinflammation. 2019;16:40.

Henry R.J. et al. Microglial priming in pediatric TBI. Brain Behav Immun. 2021;92:1–14.

Rogers J.M., Read C.A. Pediatric neurocognitive sequelae. Child Neuropsychology. 2020;26(1):1–26.

Babikian T., Asarnow R. Long-term outcomes after pediatric TBI. Curr Opin Neurol. 2020;33(6):696–702.