Nielsen, KatieCaporal, PaulaDíaz, FrancoGonzález-Dambrauskas, SebastiánVásquez-Hoyos, PabloDomínguez-Rojas, Jesús2024-07-302024-07-302024Neurosurgery, Vol. 94, N°5, (2024) p. 79-80.0148-396Xhttp://hdl.handle.net/20.500.12254/3789Pediatric traumatic brain injury is a major public health concern, particularly in resource-limited settings where this entity has higher incidence and mortality than developed nations. Despite the disproportionate burden of pediatric traumatic brain injury in low- and middle-income countries (LMICs), the current Brain Trauma Foundation guidelines are largely based on low-quality evidence generated in high-income countries (HICs).1 Adherence to guidelines is challenging in LMICs because of economic constraints, equipment availability, and human resources,2 which may explain disparities in outcomes. We applaud Chesnut et al3 for publishing a randomized controlled trial (RCT) protocol to test the hypothesis of whether intracranial pressure (ICP) monitoring improves outcomes in pediatric severe TBI (psTBI). The RCT will compare outcomes for children receiving ICP-based vs clinical examination and imaging-based management. Their main objective is to generate class I evidence regarding the impact of ICP-driven management in psTBI on long-term outcomes.enAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)Corresponding articleSevere pediatric traumaticClinical examination without ICPArticlehttp://orcid.org/0000-0003-4763-074Xhttps://doi.org/10.1227/neu.00000000000029151524-4040