Complicated Mild Traumatic Brain Injury at a Level I Pediatric Trauma Center: Burden of Care and Imaging Findings

Hansen, Chuck; Battikha, Maya; Teramoto, Masaru

doi:10.1016/j.pediatrneurol.2018.09.015

Cited by 10 publications

(11 citation statements)

References 31 publications

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“…Our results are in line with existing literature, with 80% mild TBI assessed by GCS 2 . The occurrence of complicated mild TBI and skull fractures was slightly higher than referred by Hansen et al 5 . The proportion of severe injuries was slightly higher since OUH is a trauma referral center; thus, more severe TBI patients were transferred to OUH from other hospitals in the region.…”

Section: Severity Gradesmentioning

confidence: 50%

“…Traditionally the GCS 6 defines the injury severity evaluated by the level of unconsciousness at injury time or later. Mild TBI has been classified as a complicated mild TBI (presence of trauma-related intracranial abnormality) or uncomplicated (absence of any traumatic intracranial injury) 5 . AIS head is a consensus-derived, global severity scoring system for assessing TBI severity, based on medical records and radiology.…”

Section: Inclusionmentioning

confidence: 99%

“…Traditionally, the severity of TBI is evaluated by the level of unconsciousness at injury time by the Glasgow coma scale (GCS). Mild TBI can be further classified as a complicated (presence of trauma-related intracranial abnormality) or uncomplicated (absence of any traumatic intracranial injury) 5 . The abbreviated injury scale (AIS) can estimate brain injury severity by the grade of anatomic brain injury based on neuroimaging and clinical features 6 .…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Dahl

Anđelić

Løvstad

et al. 2021

European Journal of Paediatric Neurology

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Section: Severity Gradesmentioning

confidence: 50%

Section: Inclusionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Dahl

Anđelić

Løvstad

et al. 2021

European Journal of Paediatric Neurology

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“…The pediatric GCS was used for children below 3 years (43). Mild TBI (mTBI) was further classified as uncomplicated or complicated depending on evidence of traumarelated intracranial abnormalities on CT or MRI (4,44). Brain injury severity was also assessed with the Abbreviated Injury Scale (AIS), using the brain injury AIS score (45,46).…”

Section: Severitymentioning

confidence: 99%

“…This is a larger proportion than commonly found, especially when including non-hospitalized children. For instance, a recent study of 1,771 pediatric patients presenting at the emergency department or directly to the trauma center in USA found that only 18.6% were classified as complicated mild injuries (44). The distribution of severity was not surprising, as children with high-risk trauma or in need of a CT scan will be hospitalized in Oslo and surrounding areas, thus leading to a bias toward more severe mTBI cases in hospitalized samples.…”

Section: Demographic and Injury Characteristicsmentioning

confidence: 99%

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

et al. 2022

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Descriptions of clinical outcomes in pediatric traumatic brain injury (pTBI) in Scandinavia are sparse. The Oslo site of the European CENTER-TBI study has performed a pTBI outcome study in a hospitalized population. The main objective was to investigate neuropsychological outcomes, self- and parent-reported symptoms associated with brain injury, and quality of life in children aged 1–15 years, 5–8 months after injury. Fifty-two children were included, and 45 completed the assessments. The sample consisted of 15.4% severe, 21.2% moderate, and 63.4% mild TBI. Subjectively experienced problems with concentration and fatigue were reported by the parents of nearly half of the children. Higher brain injury symptom load was associated with lower quality of life, but was unrelated to injury severity. Group average scores of the sample on neuropsychological testing appeared unimpaired relative to normative means aside from lower performance in working memory. However, based on an impairment index (i.e., 2 or more tests being >1.5 SD below the normative mean), the presence of weak cognitive performance was evident in as many as 45.4% of the sample. Two-thirds of the sample also showed abnormally large intraindividual variability in cognitive functioning (i.e., significant WISC-IV index discrepancies). The findings highlight the need to look beyond group averages on neuropsychological testing. Utilizing an impairment index and considering intraindividual performance variability conveyed deficits that may warrant clinical follow-up. The association of brain injury symptoms with quality of life but not injury severity emphasizes the need to consider symptoms after TBI within a biopsychosocial framework.Clinical Trial Registration:ClinicalTrials.gov; identifier: NCT02210221.

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Sport participation among children with complicated mild traumatic brain injury

Hansen

Teramoto

Gardner

et al. 2023

PM&R

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BackgroundComplicated mild traumatic brain injury (C‐mTBI) represents mTBI with positive trauma‐related radiographic findings, such as hematoma. It is estimated that 7.5% of all pediatric mTBIs meet these criteria. There is a paucity of research on return to sports in children with C‐mTBI.ObjectiveTo examine children with C‐mTBI, mTBI with skull fracture (mTBI‐SF) only and mTBI in relation to sport participation and factors associated with repeated injury.DesignCross‐sectional survey.SettingLevel I pediatric trauma center.ParticipantsParents of children who were 5–18 years of age at the time of injury who sustained C‐mTBI or mTBI from 2010 to 2013.InterventionsNot applicable.Main Outcome MeasuresSports participation characteristics before and after injury in children with C‐mTBI and mTBI as a function of degree and length of recovery. Repeat mTBI after the index injury was also examined.ResultsOf 247 children who participated in sports preinjury (27.5% with C‐mTBI and 9.7% with mTBI‐SF), 95.1% returned to sports. There was no significant difference by mTBI type regarding participation in any sports (p = .811) nor with high‐risk sports (p = .128). C‐mTBI but not mTBI‐SF (versus mTBI) was associated with lower odds of sustaining a repeat mTBI (odds ratio = 0.30, p = .045). Waiting longer (>3 months compared to <1 month) to return to contact sports was associated with lower odds of sustaining a repeat mTBI (odds ratio = 0.23, p < .05).ConclusionsChildren with C‐mTBI and mTBI‐SF resume similar sports as children with mTBI. Those with C‐mTBI and those who take longer to return to play may have lower risk of repeat mTBIs. Prospective research is needed to inform the development of evidence‐based guidelines for children with C‐mTBI and mTBI‐SF.

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Complicated Mild Traumatic Brain Injury at a Level I Pediatric Trauma Center: Burden of Care and Imaging Findings

Cited by 10 publications

References 31 publications

Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Epidemiology of traumatic brain injury in children 15 years and younger in South-Eastern Norway in 2015–16. Implications for prevention and follow-up needs

Neuropsychological Impairment, Brain Injury Symptoms, and Health-Related Quality of Life After Pediatric TBI in Oslo

Sport participation among children with complicated mild traumatic brain injury

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