Cognitive and behavioral outcome following mild traumatic head injury in children

Objectives: To investigate outcome in children with mild traumatic head inj ury (THI) at 1 week and 3 months postinjury and to identify factors associa ted with persisting problems. Design: Postconcussional symptomatology, beha vior ratings, and neuropsychological test performance mere examined at 1 we ek and 3 months postinjury. Setting: Participants were recruited from succe ssive presentations to emergency departments of two major hospitals. Partic ipants: 130 Children with mild THI were compared with 96 children having ot her minor injuries as controls. Results: Children with mild THI experienced headaches, dizziness, and fatigue but exhibited no cognitive impairments, relative to controls, at 1 week postinjury. By 3 months, symptoms had resol ved. However, 17% of children showed significant ongoing problems. They wer e more likely to have a history of previous head injury, learning difficult ies, neurological or psychiatric problems, or family stressors. Conclusions : Persisting problems following mild head injury in children are more commo n in those with previous head injury, preexisting learning difficulties, or neurological, psychiatric, or family problems. These "at-risk" children sh ould be identified in the emergency department and monitored.