The Long-term Impact and Rehabilitation of Pediatric Traumatic Brain Injury

Abstract

Despite significant advances in the understanding of pediatric traumatic brain injury (TBI)-related sequelae, members of the medical community working with adult survivors often do not appreciate the impact of "latent" effects of these injuries. To assess deficits and facilitate intervention, the interactions among the nature of the TBI, the individual's developmental course, and the history of community response must be understood. This case study discusses the lifelong challenges faced by a 56-year-old individual who sustained a TBI at age 5. His case highlights the importance of developmental stage consideration, remote evaluation/intervention, and collaboration with mental health professionals.

Traumatic Brain Injury in Young Rats Leads to Progressive Behavioral Deficits Coincident with Altered Tissue Properties in Adulthood

“…In human subjects, these impairments last from a few months to 50 years post-injury, and impact activities of daily living (Brenner et al, 2007;Yeates et al, 2002). A wide range of deficits have been clinically described, including slowed information processing, impaired judgment, attention-deficit/ hyperactivity disorder, hampered reasoning and problemsolving skills, mood disorders, anxiety, aggression, and antisocial behaviors (Brenner et al, 2007;Cattelani et al, 1998;Max et al, 2004;Prigatano, 2008).…”

“Trying to Get a Grip”: Language Competence and Self-Reported Satisfaction With Social Relationships Three Decades Post-Childhood Traumatic Brain Injury

“…Therefore, this study reports findings on language and social outcomes in a group of adults who had sustained childhood TBI several decades prior to testing, comparing outcomes in survivors of a TBI with abilities observed in carefully matched peers who never had a TBI. Guided by previous evidence, 16,18,19,62 it was hypothesized that, if present, impairments in language competence would be associated with reduced self-reported satisfaction with social relationships in the current sample of long-term survivors of childhood TBI.…”

“…23 Indeed, these notions were proven to be a misconception with studies showing that childhood TBI can result in lifelong impairments in language and social functioning. 7,18,19,21 In children, falls and motor vehicle accidents are among the most common causes of TBI, 2,24 exposing the developing brain to sudden accelerationdeceleration and rotational forces. 25,26 The resulting neurological damage is typically diffuse in nature, presenting as shearing or tearing of axonal fibers, alterations in blood flow and focal contusions and bruising.…”

“…Finally, in a 50-year follow-up case study, impairments in social judgment and inappropriate pragmatic features were found to be existent in the same participant. 19 Although these initial findings are alarming, several important gaps in the literature on long-term language and social outcomes remain. First, previous attempts to delineate this link beyond a short-term time span postinjury encountered a number of methodological limitations, such as large attrition rates, 16 being a case study, 19 as well as small sample sizes and lack of comparison group 18 ; all of which limit the generalizability of these previously reported findings.…”

“…19 Although these initial findings are alarming, several important gaps in the literature on long-term language and social outcomes remain. First, previous attempts to delineate this link beyond a short-term time span postinjury encountered a number of methodological limitations, such as large attrition rates, 16 being a case study, 19 as well as small sample sizes and lack of comparison group 18 ; all of which limit the generalizability of these previously reported findings. Second, the contribution of language proficiency to social outcomes in larger samples is not reliably documented beyond 14 years postinjury, and it remains yet to be established whether language ability continues to contribute to social outcomes in the longer-term postinjury.…”