Long-Term Outcomes Following Pediatric Concussion/Mild Traumatic Brain Injury

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It seems that time following pediatric head injury is not all that is required for children to recover following a mild traumatic brain injury – sometimes described as “just a concussion.” Pediatric brain injury – even in its mildest form – can have long-term adverse consequences for quality of life, behavioral and emotional adjustment, executive function, and social participation. These domains also have a major impact on vocational abilities and success.

What the Studies Suggest

Contrary to a myth popularized by “old school” pediatricians, neurologists, neuropsychologists, and psychiatrists, more than a small subset of brain injury patients suffer from long-term symptoms of traumatic brain injury. In fact, some of the most contemporary and well-controlled studies suggest that somewhere between 20- 50% of mTBI patients experience adverse symptoms at one year, as opposed to the mythical recovery within three months. Long-Term Presentation of Postconcussion Symptoms and Associated Factors: Analysis of Latent Class Modeling – PubMed (nih.gov); Nelson LD, Temkin NR, Dikmen, et al,  Recovery After Mild Traumatic Brain Injury in Patients Presenting to US Level I Trauma Centers: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. JAMA Neurol. 2019 Sep 1;76(9):1049-1059. DOI: 10.1001/jamaneurol.2019.1313. Erratum in: JAMA Neurol. 2019 Dec 1;76(12):1520. PMID: 31157856; PMCID: PMC6547159.

A recent nested case-controlled study published in Frontiers of Neurology (Front. Neurol., 23 July 2021 |https://doi.org/10.3389/fneur.2021.683661), “Parent and Teacher-Reported Child Outcomes Seven Years After Mild Traumatic Brain Injury: A Nested Case-Control Study,” followed pediatric patients to seven years following mild traumatic brain injury (concussion) with results that suggested continuing problems consistent with the index injury.

Seek Qualified Experts

What if my child has suffered a concussion or worse? Seek out qualified experts in the field. My decades of personal experience in this field have informed me that a child’s pediatrician may be a terrific physician but may lack expertise in the brain injury field. There are a variety of health care providers who are qualified to treat a wide range of physical, cognitive, emotional, and behavioral symptoms that may follow a concussion.

By Stewart M. Casper. Posted August 2, 2021