Objective: We aimed to investigate psychosocial changes such as burnout, caregiver burden, depression, and coping in mothers of children with cerebral palsy (CP) after tracheostomy placement. Design: A total of 48 children with CP and chronic respiratory insufficiency and their mothers participated in the study. The children with tracheostomy were classified as T (+) (n = 26) and those who did not have tracheostomy were classified as T (−) (n = 22). The patients with tracheostomy through invasive mechanical ventilation were classified as TIV (+). The data about the clinical conditions of the patients and the sociodemographic characteristics of the mothers were recorded. Zarit caregiver burden, Maslach burnout, Beck depression, and Coping Orientation to Problems Experienced (COPE) questionnaires were applied to all mothers.Findings: Beck depression score was 14 ± 8.24 in T (+) group and 16.09 ± 9.65 in T (−) group (p = .576). There was no significant difference between the T (+) and T (−) groups in the Maslach burnout inventory, Zarit caregiver burden scale, and their subgroups. The first two methods from the COPE scales were identical. In theT (+) group, the third coping method was found as "planning" and in the T (−) group as "active coping". Maslach burnout inventory, Zarit 1, and Zarit 2 scores were higher in patients with only tracheostomy compared to those with TIV (p = .002, p = .018, p = .021). Conclusion:In the study presented, the placement of tracheostomy in children with CP does not increase mother's depression tendencies and mood changes.

Background. Internal carotid artery dissection (ICAD) is a rare but potentially devastating complication after trauma in the pediatric age group. The diagnosis of traumatic dissection is difficult and is usually recognized only when ischemic symptoms appear. We report a pediatric patient with ICAD due to blunt cerebrovascular injury (BCVI). Case. A 14-year-old boy suffered major trauma due to a motor vehicle accident. When the first aid team reached the accident site, he was intubated because of his low Glasgow Coma Score (GCS) and then transported to the nearest emergency department. Cranial computed tomography (CT) showed multiple fractures at the skull base and independent bone fragments in both carotid canals. On the 6th day; a brain magnetic resonance imaging (MRI) was performed to detect diffuse axonal injury. There was a loss of signal in the left internal carotid artery (LICA) tract but the limitation of diffusion was not associated with the same side, conversely there was a limitation of diffusion on the other side, affecting a very large area. CT angiography was performed in order to detect a filling defect and showed dissection in the LICA. The patient did not have any specific neurological symptoms associated with ICAD. Low-dose aspirin was utilized as anticoagulant therapy. On the 25th day of admission, the patient`s GCS was 14, neurologic examination showed no difference between the right and left sides. He was discharged on the 55th day of the accident and was walking without support. Conclusion. Our patient was a rare case in pediatrics due to having a clinically silent form of ICAD. It is very difficult to diagnose ICAD dissection during the early phase in cases with BCVI accompanied by multiple trauma. Even in the absence of typical neurological deficit, the possible presence of ICAD should be explored in patients with cranial fractures encompassing the skull base.