Mild Traumatic Brain Injury in Children: Ringing the Alert Bell

Abstract

Despite the high incidence of mild head injuries in children, only recently has there been increasing interest which began when findings from research done in adult patients showed that the effects of mild closed head injuries could interfere significantly with employment and other areas of life. Mild traumatic brain injury (TBI) is a common occurrence around the world and in the United States, its estimated incidence exceeding 1 million injuries per year, with cognitive, emotional, behavioral, and physical impairments as common sequelae. The etiology of these symptoms in individuals with mild TBI is controversial, with hypotheses of postconcussive symptom formation variously ascribing greater or lesser weight to neural damage, psychiatric factors, somatization, malingering, or some combination of these. TBI in children is an enormous problem., as many children will encounter a brain injury. Adolescents and families need to self-monitor symptoms and limit environments or circumstances that exacerbate any symptoms. When symptoms resolve, a gradual progressive return to play is currently recommended. The recurrence risk for subsequent concussions is elevated, but there is limited documentation of the effectiveness of preventative efforts. This review will limit itself to what may refer to as minor traumatic brain injury, primarily in children, with a focus on the assessment and management of this complexity.