REHABILITATION AND FOLLOW-UP OF CHILDREN WITH SEVERE TRAUMATIC BRAIN INJURY

We studied the outcome of 25 patients [12 girls and 13 boys; mean age 13.7 (SD 3.9 years)] with severe traumatic brain injury (TBI). The Gla sgow Coma Scale (GCS) score 6 h after the injury was (mean) 4.5 (SD 2. 7), and the mean duration of unconsciousness was 15.8 (SD 10.6) days. Being the mast severely brain-injured children in the health care regi on, they were all referred to its only regional pediatric rehabilitati on center during 1986-1990. At discharge, 1 patient was healthy, 1 was in a vegetative state and 18 had multiple impairments. Motor problems were present in 22, epilepsy in 7 and speech impairment in 14. It was not possible to assess cognition in 3 of the children, and 15 of the remaining 22 fell in the normal range. At follow up 2-6 years after tr auma, all 23 survivors reported at least one sequela, and 21 had multi ple sequelae. As many as two-thirds had normal I.Q. and only 3 were no n-ambulatory, but behavioral and personality disturbances were so disa bling that none of the patients in this group had been able to readjus t to a normal life in society after the trauma.