Research Reports - Do concussive symptoms really resolve in young children?

J Head Trauma Rehabil. 2017 Apr 18. doi: 10.1097/HTR.0000000000000298. [Epub
ahead of print]

Bernard CO(1), Ponsford JL, McKinlay A, McKenzie D, Krieser D.

OBJECTIVES: To examine the frequency and nature of postconcussive symptoms (PCSs)
and behavioral outcomes in young children following mild traumatic brain injury
(mTBI) or concussion.
SETTING: Emergency department.
PARTICIPANTS: Children aged 2 to 12 years presenting with either a concussion or
minor bodily injury (control).
OUTCOME MEASUREMENT: Parent ratings of PCS were obtained within 72 hours of
injury, at 1 week, and 1, 2, and 3 months postinjury using a comprehensive PCS
checklist. Preinjury behavior was examined at baseline using the Clinical
Assessment of Behavior, which was readministered 1 and 3 months postinjury.
RESULTS: PCS burden following mTBI peaked in the acute phase postinjury but
reduced significantly from 1 week to 1 month postinjury. Parents of children with
mTBI reported more persistent PCSs up to 3 months postinjury than trauma
controls, characterized mostly by behavioral and sleep-related symptoms. Subtle
increases in problematic behaviors were observed from baseline (preinjury) to 1
month postinjury and persisted at 3 months postinjury; however, scores were not
classified as clinically "at risk."
CONCLUSIONS: A significant minority of young children experienced persistent PCS
and problematic behavior following mTBI. Care must be taken when assessing PCS in
younger children as method of PCS assessment may influence parental reporting. 

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