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Mild traumatic brain injury and postconcussive symptoms in children and adolescents

Published online by Cambridge University Press:  25 August 2010

KEITH OWEN YEATES*
Affiliation:
Center for Biobehavioral Health, The Research Institute at Nationwide Children’s Hospital & Department of Pediatrics, The Ohio State University, Columbus, Ohio
*
*Correspondence should be addressed to Keith Owen Yeates, Department of Psychology, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205. E-mail: [email protected].

Abstract

The vast majority of traumatic brain injuries (TBI) in children are of mild severity. Even if only a small proportion of children with mild TBI suffer negative outcomes, then mild TBI is a serious public health problem. This review summarizes the literature regarding the neurobehavioral outcomes associated with mild TBI in children and adolescents, focusing on the longstanding debate regarding postconcussive symptoms and attendant conceptual and methodological issues. The review also discusses future research directions, the long-term goal of which is to develop a comprehensive and integrated biopsychosocial model of outcomes that helps guide clinical management. (JINS, 2010, 16, 953–960.)

Type
Short Review
Copyright
Copyright © The International Neuropsychological Society 2010

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References

REFERENCES

Alexander, M.P. (1997). Minor traumatic brain injury: A review of physiogenesis and psychogenesis. Seminars in Clinical Neuropsychiatry, 1, 177187.Google Scholar
American Academy of Neurology. (1997). Practice parameter: The management of concussion in sports (summary statement). Report of the Quality Standards Subcommittee. Neurology, 48, 581585.CrossRefGoogle Scholar
American Academy of Pediatrics. (1999). The management of minor closed head injury in children. Pediatrics, 104, 14071415.CrossRefGoogle Scholar
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Asarnow, R.F., Satz, P., Light, R., Zaucha, K., Lewis, R., & McCleary, C. (1995). The UCLA study of mild head injury in children and adolescents. In Michel, M.E. & Broman, S. (Eds.), Traumatic head injury in children (pp. 117146). New York: Oxford University Press.Google Scholar
Ashwal, S., Tong, K.A., Obenaus, A., & Holshouser, B.A. (2010). Advanced neuroimaging techniques in children with traumatic brain injury. In Anderson, V.A. & Yeates, K.O. (Eds.), New directions in pediatric traumatic brain injury: Multidisciplinary and translational perspectives (pp. 6893). New York: Oxford University Press.CrossRefGoogle Scholar
Ayr, L.K., Yeates, K.O., Taylor, H.G., & Browne, M. (2009). Dimensions of post-concussive symptoms in children with mild traumatic brain injuries. Journal of the International Neuropsychological Society, 15, 1930.CrossRefGoogle Scholar
Babikian, T., & Asarnow, R. (2009). Neurocognitive outcomes and recovery after pediatric TBI: Meta-analytic review of the literature. Neuropsychology, 23, 283296.CrossRefGoogle ScholarPubMed
Barlow, K.M., Crawford, S., Stevenson, A., Sandhu, S.S., Belanger, F., & Dewey, D. (2010). A prospective epidemiological study of post-concussion syndrome in pediatric mild traumatic brain injury. Pediatrics, 126, 374381.CrossRefGoogle ScholarPubMed
Bazarian, J.J., McClung, J., Shah, M.N., Cheng, Y.T., Flesher, W., & Kraus, J. (2005). Mild traumatic brain injury in the United States, 1998–2000. Brain Injury, 19, 8591.CrossRefGoogle ScholarPubMed
Berger, R.P., Hayes, R.L., Wang, K.K.W., & Kochanek, P. (2010). Using serum biomarkers to diagnose, assess, treat and predict outcome after pediatric TBI. In Anderson, V.A. & Yeates, K.O. (Eds.), New directions in pediatric traumatic brain injury: Multidisciplinary and translational perspectives (pp. 3653). New York: Oxford University Press.CrossRefGoogle Scholar
Bigler, E.D. (2008). Neuropsychology and clinical neuroscience of persistent post-concussive syndrome. Journal of the International Neuropsychological Society, 14, 122.CrossRefGoogle ScholarPubMed
Bijur, P.E., & Haslum, M. (1995). Cognitive, behavioral, and motoric sequelae of mild head injury in a national birth cohort. In Broman, S. & Michel, M.E. (Eds.), Traumatic head injury in children (pp. 147164). New York: Oxford University Press.Google Scholar
Binder, L.M. (1986). Persisting symptoms after mild head injury: A review of the postconcussive syndrome. Journal of Clinical and Experimental Neuropsychology, 8, 323346.CrossRefGoogle ScholarPubMed
Boake, C., McCauley, S.R., Levin, H.S., Contant, C.F., Song, J.X., Brown, S.A., et al. . (2004). Limited agreement between criteria-based diagnoses of Postconcussional syndrome. Journal of Neuropsychiatry and Clinical Neurosciences, 16, 493499.CrossRefGoogle ScholarPubMed
Boake, C., McCauley, S.R., Levin, H.S., Pedroza, C., Contant, C.F., Song, J.X., et al. . (2005). Diagnostic criteria for postconcussional syndrome after mild to moderate traumatic brain injury. Journal of Neuropsychiatry and Clinical Neurosciences, 17, 350356.CrossRefGoogle ScholarPubMed
Bodin, D., Yeates, K.O., & Klamar, K. (in press). Definition and classification of concussion. In Apps, J.N. & Walter, K. (Eds.), Handbook of pediatric concussion. New York: Guilford Press.Google Scholar
Bowman, S.M., Bird, T.M., Aitken, M.E., & Tilford, J.M. (2008). Trends in hospitalizations associated with pediatric traumatic brain injuries. Pediatrics, 122, 988993.CrossRefGoogle ScholarPubMed
Brown, S.J., Fann, J.R., & Grant, I. (1994). Postconcussional disorder: Time to acknowledge a common source of neurobehavioral morbidity. Journal of Neuropsychiatry and Clinical Neurosciences, 6, 1522.Google ScholarPubMed
Bryant, R.A., & Harvey, A.G. (1999). Postconcussive symptoms and posttraumatic stress disorder after mild traumatic brain injury. The Journal of Nervous and Mental Disease, 187, 302305.CrossRefGoogle ScholarPubMed
Carroll, L.J., Cassidy, J.D., Holm, L., Kraus, J., & Coronado, V.G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: The WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl.), 113125.CrossRefGoogle Scholar
Carroll, L.J., Cassidy, J.D., Peloso, P.M., Borg, J., von Holst, H., Holm, L., et al. . (2004). Prognosis for mild traumatic brain injury: Results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, 43(Suppl.), 84105.CrossRefGoogle Scholar
Dikmen, S.S., & Levin, H.S. (1993). Methodological issues in the study of mild head injury. Journal of Head Trauma Rehabilitation, 8, 3037.CrossRefGoogle Scholar
Drotar, D., Stein, R.E.K., & Perrin, E.C. (1995). Methodological issues in using the Child Behavior Checklist and its related instruments in clinical child psychology research. Journal of Clinical Child Psychology, 24, 184192.CrossRefGoogle Scholar
Durham, S.R., Clancy, R.R., Leuthardt, E., Sun, P., Kamerling, S., Dominquez, T., et al. . (2000). CHOP Infant Coma Scale (‘Infant Face Scale’): A novel coma scale for children less than 2 years of age. Journal of Neurotrauma, 17, 729737.CrossRefGoogle Scholar
Fay, G.C., Jaffe, K.M., Polissar, N.L., Liao, S., Martin, K.M., Shurtleff, H.A., et al. . (1993). Mild pediatric traumatic brain injury: A cohort study. Archives of Physical Medicine and Rehabilitation, 74, 895901.Google ScholarPubMed
Fay, T.B., Yeates, K.O., Taylor, H.G., Bangert, B., Dietrich, A., Nuss, K.E., et al. . (2009). Cognitive reserve as a moderator of postconcussive symptoms in children with complicated and uncomplicated mild traumatic brain injury. Journal of the International Neuropsychological Society, 16, 94105.CrossRefGoogle ScholarPubMed
Francis, D.J., Fletcher, J.M., Stuebing, K.K., Davidson, K.C., & Thompson, N.M. (1991). Analysis of change: Modeling individual growth. Journal of Consulting and Clinical Psychology, 59, 2737.CrossRefGoogle ScholarPubMed
Gagnon, I., Galli, C., Friedman, D., Grilli, L., & Iverson, G.L. (2009). Active rehabilitation for children who are slow to recover following sport-related concussion. Brain Injury, 23, 956964.CrossRefGoogle ScholarPubMed
Ganesalingam, K., Yeates, K.O., Ginn, M.S., Taylor, H.G., Dietrich, A., Nuss, K., et al. . (2008). Family burden and parental distress following mild traumatic brain injury in children and its relationship to post-concussive symptoms. Journal of Pediatric Psychology, 33, 621629.CrossRefGoogle ScholarPubMed
Gerring, J.P., Brady, K.D., Chen, A., Vasa, R., Grados, M., Bandeen-Roche, K.J., et al. . (1998). Premorbid prevalence of ADHD and development of secondary ADHD after closed head injury. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 647654.CrossRefGoogle ScholarPubMed
Gioia, G.A., Collins, M., & Isquith, P.K. (2008). Improving identification and diagnosis of mild traumatic brain injury with evidence: Psychometric support for the Acute Concussion Evaluation. Journal of Head Trauma Rehabilitation, 23, 230242.CrossRefGoogle ScholarPubMed
Gioia, G.A., Schneider, J.C., Vaughan, C.G., & Isquith, P.K. (2009). Which symptom assessments and approaches are uniquely appropriate for paediatric concussion? British Journal of Sports Medicine, 43(Suppl. I), i13i22.CrossRefGoogle ScholarPubMed
Giza, C.C., & Hovda, D.A. (2001). The neurometabolic cascade of concussion. Journal of Athletic Training, 36, 228235.Google ScholarPubMed
Hajek, C.A., Yeates, K.O., Taylor, H.G., Bangert, B., Dietrich, A., Nuss, K., et al. . (in press). Agreement between parents and children on ratings of postconcussive symptoms following mild traumatic brain injury. Child Neuropsychology.Google Scholar
Hajek, C.A., Yeates, K.O., Taylor, H.G., Bangert, B., Dietrich, A., Nuss, K., et al. . (2010). Relationships among postconcussive symptoms and symptoms of PTSD in children following mild traumatic brain injury. Brain Injury, 24, 100109.CrossRefGoogle ScholarPubMed
Hawley, C.A. (2003). Reported problems and their resolution following mild, moderate, and severe traumatic brain injury amongst children and adolescents in the UK. Brain Injury, 17, 105129.CrossRefGoogle ScholarPubMed
Iverson, G.L., Brooks, B.L., Ashton, V.L., & Lange, R.T. (2010). Interview versus questionnaire symptom reporting in people with the postconcussion syndrome. The Journal of Head Trauma Rehabilitation, 25, 2330.CrossRefGoogle ScholarPubMed
Iverson, G.L., Brooks, B.L., Collins, M.W., & Lovell, M.R. (2006). Tracking neuropsychological recovery following concussion in sport. Brain Injury, 20, 245252.CrossRefGoogle ScholarPubMed
Jordan, B.D. (2007). Genetic influences on outcome following traumatic brain injury. Neurochemical Research, 32, 905915.CrossRefGoogle ScholarPubMed
Kamerling, S.N., Lutz, N., Posner, J.C., & Vanore, M. (2003). Mild traumatic brain injury in children: Practice guidelines for emergency department and hospitalized patients. Pediatric Emergency Care, 19, 431440.CrossRefGoogle ScholarPubMed
Kashluba, S., Paniak, C., & Casey, J.E. (2008). Persistent symptoms associated with factors identified by the WHO Task Force on Mild Traumatic Brain Injury. The Clinical Neuropsychologist, 22, 195208.CrossRefGoogle ScholarPubMed
Kirkwood, M.W., Yeates, K.O., Taylor, H.G., Randolph, C., McCrea, M., & Anderson, V.A. (2008). Management of pediatric mild traumatic brain injury: A neuropsychological review from injury through recovery. The Clinical Neuropsychologist, 22, 769800.CrossRefGoogle ScholarPubMed
Kraus, J.F. (1995). Epidemiological features of brain injury in children: Occurrence, children at risk, causes and manner of injury, severity, and outcomes. In Broman, S.H. & Michel, M.E. (Eds.), Traumatic head injury in children (pp. 2239). New York: Oxford University Press.Google Scholar
Laursen, B., & Hoff, E. (2006). Person-centered and variable-centered approaches to longitudinal data. Merrill-Palmer Quarterly, 52, 377389.CrossRefGoogle Scholar
Levin, H.S., Hanten, G., Roberson, G., Li, X., Ewing-Cobbs, L., Dennis, M., et al. . (2008). Prediction of cognitive sequelae based on abnormal computed tomography findings in children following mild traumatic brain injury. Journal of Neurosurgery, 1, 461470.Google ScholarPubMed
Light, R., Asarnow, R., Satz, P., Zucha, K., McCleary, C., & Lewis, R. (1998). Mild closed-head injury in children and adolescents: Behavior problems and academic outcomes. Journal of Consulting and Clinical Psychology, 66, 10231029.CrossRefGoogle ScholarPubMed
Lishman, W.A. (1988). Physiogenesis and psychogenesis in the post-concussion syndrome. British Journal of Psychiatry, 153, 460469.CrossRefGoogle Scholar
Luis, C.A., Vanderploeg, R.D., & Curtiss, G. (2003). Predictors of postconcussion symptom complex in community dwelling male veterans. Journal of the International Neuropsychological Society, 9, 10011015.CrossRefGoogle ScholarPubMed
McCrea, M., Barr, W.B., Guskiewicz, K., Randolph, C., Marshall, S.W., Cantu, R., et al. . (2005). Standard regression-based methods for measuring recovery after sport-related concussion. Journal of the International Neuropsychological Society, 11, 5869.CrossRefGoogle ScholarPubMed
McCrory, P., Meeuwisse, W., Johnston, K., Dvorak, J., Aubry, M., Molloy, M., et al. . (2009). Consensus statement on concussion in sport 3rd International Conference on Concussion in Sport Held in Zurich, November 2008. Clinical Journal of Sports Medicine, 19, 185195.CrossRefGoogle ScholarPubMed
McKinlay, A. (2009). Controversies and outcomes associated with mild traumatic brain injury in childhood and adolescence. Child: Care, Health, and Development, 36, 321.CrossRefGoogle Scholar
McKinlay, A., Dalrymple-Alford, J.C., Horwood, L.J., & Fergusson, D.M. (2002). Long term psychosocial outcomes after mild head injury in early childhood. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 281288.CrossRefGoogle ScholarPubMed
McKinlay, A., Kyonka, E.G.E., Grace, R.C., Horwood, L.J., Fergusson, D.M., & MacFarlane, M.R. (2010). An investigation of the pre-injury risk factors associated with children who experience traumatic brain injury. Injury Prevention, 16, 3135.CrossRefGoogle ScholarPubMed
Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8, 8687.CrossRefGoogle Scholar
Mittenberg, W., Wittner, M.S., & Miller, L.J. (1997). Postconcussion syndrome occurs in children. Neuropsychology, 11, 447452.CrossRefGoogle ScholarPubMed
Moran, L.M., Taylor, H.G., Ganesalingam, K., Gastier-Foster, J.M., Frick, J., Bangert, B., et al. . (2009). Apolipoprotein E4 as a predictor of outcomes in pediatric mild traumatic brain injury. Journal of Neurotrauma, 26, 14891495.CrossRefGoogle ScholarPubMed
Nacajauskaite, O., Endziniene, M., Jureniene, K., & Schrader, H. (2006). The validity of post-concussion syndrome in children: A controlled historical cohort study. Brain and Development, 28, 507514.CrossRefGoogle ScholarPubMed
Nagin, D.S. (2005). Group-based modeling of development. Cambridge, MA: Harvard University Press.CrossRefGoogle Scholar
National Center for Injury Prevention and Control. (2003). Report to Congress on mild traumatic brain injury in the United States: Steps to prevent a serious public health problem. Atlanta: Centers for Disease Control and Prevention.Google Scholar
NIH Consensus Panel on Rehabilitation of Persons with Traumatic Brain Injury. (1999). Rehabilitation of persons with traumatic brain injury. Journal of the American Medical Association, 282, 974983.CrossRefGoogle Scholar
Nolin, P., Villemure, R., & Heroux, L. (2006). Determining long-term symptoms following mild traumatic brain injury: Method of interview affects self-report. Brain Injury, 20, 11471154.CrossRefGoogle ScholarPubMed
Overweg-Plandsoen, W.C.G., Kodde, A., van Straaten, M., van der Linden, E.A.M., Neyens, L.G.J., Aldenkamp, A.P., et al. . (1999). Mild closed head injury in children compared to traumatic fractured bone; neurobehavioural sequelae in daily life 2 years after the accident. European Journal of Pediatrics, 158, 249252.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Ayton, G., Nelms, R., et al. . (1999). Cognitive and behavioral outcomes following mild traumatic head injury in children. Journal of Head Trauma Rehabilitation, 14, 360372.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Ayton, G., Nelms, R., et al. . (2001). Impact of early intervention on outcome after mild traumatic brain injury in children. Pediatrics, 108, 12971303.CrossRefGoogle ScholarPubMed
Ponsford, J., Willmott, C., Rothwell, A., Cameron, P., Kelly, A.-M., Nelms, R., et al. . (2000). Factors influencing outcome following mild traumatic brain injury in adults. Journal of the International Neuropsychological Society, 6, 568579.CrossRefGoogle ScholarPubMed
Powell, J.M., Ferraro, J.V., Dikmen, S.S., Temkin, N.R., & Bell, K.R. (2008). Accuracy of mild traumatic brain injury diagnosis. Archives of Physical Medicine and Rehabilitation, 89, 15501555.CrossRefGoogle ScholarPubMed
Rutter, M.L. (1999). Psychosocial adversity and child psychopathology. British Journal of Psychiatry, 174, 480493.CrossRefGoogle ScholarPubMed
Satz, P. (2001). Mild head injury in children and adolescents. Current Directions in Psychological Science, 10, 106109.CrossRefGoogle Scholar
Satz, P., Zaucha, K., McCleary, C., Light, R., & Asarnow, R. (1997). Mild head injury in children and adolescents: A review of studies (1970–1995). Psychological Bulletin, 122, 107131.CrossRefGoogle ScholarPubMed
Seidel, J.S., Henderson, D., Tittle, S., Jaffe, D.M., et al. . (1999). Priorities for research in emergency medical services for children: Results of a consensus conference. Annals of Emergency Medicine, 33, 206210.CrossRefGoogle ScholarPubMed
Steinberg, L., & Avenevoli, S. (2000). The role of context in the development of psychopathology: A conceptual framework and some speculative propositions. Child Development, 71, 6674.CrossRefGoogle ScholarPubMed
Taylor, H.G., & Alden, J. (1997). Age-related differences in outcome following childhood brain injury: An introduction and overview. Journal of the International Neuropsychological Society, 3, 555567.CrossRefGoogle ScholarPubMed
Taylor, H.G., Dietrich, A., Nuss, K., Wright, M., Rusin, J., Bangert, B., et al. . (2010). Post-concussive symptoms in children with mild traumatic brain injury. Neuropsychology, 24, 148159.CrossRefGoogle ScholarPubMed
Teasdale, G., & Jennett, B. (1974). Assessment of coma and impaired consciousness: A practical scale. Lancet, 2, 8184.CrossRefGoogle ScholarPubMed
Wilde, E.A., McCauley, S.R., Hunger, J.V., Bigler, E.D., Chu, Z., Wang, Z.J., et al. . (2008). Diffusion tensor imaging of acute mild traumatic brain injury in adolescents. Neurology, 70, 948955.CrossRefGoogle ScholarPubMed
Williams, D.H., Levin, H.S., & Eisenberg, H.M. (1990). Mild head injury classification. Neurosurgery, 27, 422428.CrossRefGoogle ScholarPubMed
World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.Google Scholar
Yeates, K.O., Luria, J., Bartkowski, H., Rusin, J., Martin, L., & Bigler, E.D. (1999). Post-concussive symptoms in children with mild closed-head injuries. Journal of Head Trauma Rehabilitation, 14, 337350.CrossRefGoogle Scholar
Yeates, K.O., & Taylor, H.G. (2005). Neurobehavioural outcomes of mild head injury in children and adolescents. Pediatric Rehabilitation, 8, 516.Google ScholarPubMed
Yeates, K.O., Taylor, H.G., Barry, C.T., Drotar, D., Wade, S.L., & Stancin, T. (2001). Neurobehavioral symptoms in childhood closed-head injuries: Changes in prevalence and correlates during the first year post injury. Journal of Pediatric Psychology, 26, 7991.CrossRefGoogle Scholar
Yeates, K.O., Taylor, H.G., Drotar, D., Wade, S.L., Klein, S., Stancin, T., et al. . (1997). Pre-injury family environment as a determinant of recovery from traumatic brain injuries in school-age children. Journal of the International Neuropsychological Society, 3, 617630.CrossRefGoogle Scholar
Yeates, K.O., Taylor, H.G., Rusin, J., Bangert, B., Dietrich, A., Nuss, K., et al. . (2009). Longitudinal trajectories of post-concussive symptoms in children with mild traumatic brain injuries and their relationship to acute clinical status. Pediatrics, 123, 735743.CrossRefGoogle ScholarPubMed