Are the symptoms and severity of head injury predictive of clinical findings three months later?

Abstract

The difficulties in predicting outcomes in head-injured children, especially younger ones, indicate the need for a follow-up appointment in order to identify children with special needs. Further studies are needed regarding the early signs and symptoms in different age groups.

Adolescents with Traumatic Brain Injury and their School Situation: A Qualitative Study

“…These types of consequences are quite common after a head injury (Chan 2000, Finset & Krogstad 2002, Lezak 1995, Ponsford 1995, and the results of this study do not differ in this respect from other studies in the same field. This study also supports earlier reports that TBIs have special educational needs, extending beyond the first months after their injury (Ewing-Cobbs et al 1998, Falk et al 2006, Hansen 1994, Miller & Donders 2003, Savage et al 2005, Sharp et al 2006, Taylor et al 2003. The majority were positive towards receiving individual lessons and towards having an extra teacher in the classroom.…”

Informational needs in families after their child's mild head injury

“…However, it seems reasonable to assume that a head injury suffered by their child is so stressful for a parent(s) and/or child, that the emotions surrounding this event are not likely to be forgotten. At the same time, although the general opinion is that most children recover from a mild head injury within weeks [24], several investigators have described complaints that persist for as long as 6-12 weeks [25][26][27]. Therefore, a 3-month interval was chosen here in attempt to minimize the impact of any persistent symptoms on the answers received.…”

Longitudinal Trajectories of Postconcussive Symptoms in Children With Mild Traumatic Brain Injuries and Their Relationship to Acute Clinical Status

“…Few previous studies have directly compared the outcomes of complicated (ie, more severe) versus uncomplicated (ie, less severe) mild TBI in children, but their results have generally suggested that children with more severe injuries display poorer outcomes 30,31,38,39. However, only 1 of those studies examined the occurrence of PCSs,30 and it suffered from a variety of methodologic problems (ie, small sample size, no control group).…”

“…However, only 1 of those studies examined the occurrence of PCSs,30 and it suffered from a variety of methodologic problems (ie, small sample size, no control group). As best we can tell, ours is the first study of PCSs in children that involved a definition of mild TBI that encompassed a spectrum of injury severity and also embodied other methodologic strengths, including prospective recruitment of consecutive patients, inclusion of a comparison group of children with OI, and longitudinal follow-up with minimal attrition.…”

“…Most studies have defined mild TBI in part based on Glasgow Coma Scale (GCS)29 scores ranging from 13 to 15, but the studies have been inconsistent in their use of other criteria, such as presence or duration of unconsciousness or posttraumatic amnesia. Children with positive findings on neuroimaging have often been omitted, despite evidence suggesting that so-called “complicated” mild TBI (ie, GCS score of 13–15 but with intracranial abnormalities on neuroimaging) are associated with a higher risk of negative sequelae 30,31…”