Mild traumatic brain injuries (TBIs) may cause transient or persistent symptoms in the first year after injury Mild traumatic brain injuries (TBIs), particularly those that are more severe, may cause transient or persistent symptoms in the first year after injury, according to the results of a prospective and longitudinal cohort study reported in the March issue of Pediatrics.

"This study provides reassurance for parents of kids who suffer first-time concussions because we can see that more often than not they recover fully within a short amount of time," lead author Keith Owen Yeates, PhD, from Nationwide Children's Hospital and Ohio State University College of Medicine in Columbus, said in a news release. "However, the study also shows that kids who are at risk because their concussions are more severe need to be monitored for a longer period of time as their symptoms may last longer."

The goal of this study was to assess whether mild TBIs in children and adolescents, especially when associated with acute clinical features reflecting more severe injury, result in different postinjury trajectories of postconcussive symptoms (PCSs) vs mild orthopaedic injuries (OIs).

At 2 large children's hospitals, 186 children with mild TBI and 99 with mild OI were recruited from consecutive admissions to emergency departments. Age range was 8 to 15 years. Current PCSs were rated by parents within 3 weeks of injury and at 1, 3, and 12 months after the injury. At the first evaluation, parents retrospectively rated preinjury symptoms, and children with mild TBI underwent brain magnetic resonance imaging.

Clinical characteristics evaluated for their ability to predict PCSs were loss of consciousness, Glasgow Coma Scale score less than 15, accompanying injuries, acute symptoms of concussion, and intracranial abnormalities on magnetic resonance imaging.

Four longitudinal trajectories of PCSs were determined based on finite mixture modeling; these were no PCSs, moderate persistent postconcussive symptoms, high acute/resolved PCSs, and high acute/persistent PCSs.

Distribution of trajectories differed between mild TBI and OI. Compared with the OI group, the mild TBI group was more likely to have high acute/resolved and high acute/persistent trajectories vs no PCSs. Children with mild TBI in whom the acute clinical presentation reflected more severe injury were especially likely to have high acute/resolved and high acute/persistent trajectories of symptoms.

"Parents should pay particular attention to these symptoms when they last more than a month or two and report all ongoing symptoms to their child's doctor so they can intervene appropriately," Dr. Yeates said.

Limitations of this study include recruitment rates below 50% for the mild TBI and OI groups, possible recruitment bias, and all clinical features weighted equally in the cumulative severity index and multiple symptoms summed in the measure of PCSs.

"Mild traumatic brain injuries, particularly those that are more severe, are more likely than orthopedic injuries to result in transient or persistent increases in PCSs in the first year after injury," the study authors write. "Additional research is needed to elucidate the range of factors, both injury related and non–injury related, that place some children with mild traumatic brain injuries at risk for PCSs."

Source: Medscape Medical News

TrackBack URI for this entry

Name

Website

Title

Comment smaller | bigger

Subscribe via email (registered users only)

I have read and agree to the Terms of Usage.

Add Comment