Long-Term Effects of Mild Traumatic Brain Injury Are Not So Mild

Children with closed head injuries, with or without loss of consciousness (LOC), can sustain mild traumatic brain injury (TBI). Researchers used reliable change analysis to determine the probability of increases in somatic (e.g., headache) and cognitive (e.g., inattention, forgetfulness) postinjury symptoms by comparing 186 children with mild TBI and 99 children with extremity fractures (age range, 8–15 years). Parents reported symptoms at 2 weeks and 3 and 12 months postinjury and functional impairment at 3 and 12 months.

Among children with mild TBI, 40% had LOC and 18% had brain abnormalities on magnetic resonance imaging (MRI). Overall, children with mild TBI were more likely than those with orthopedic injury to have reliable increases in somatic and cognitive symptoms at the 2-week postinjury evaluation. Reliable increases in cognitive symptoms persisted to 12 months postinjury in children with TBI and were most common in those with LOC.

Reliable increases in both somatic and cognitive symptoms at 2 weeks predicted lower ratings of physical health-related quality of life (HRQOL) at 3 months postinjury. Reliable increases in cognitive symptoms at 3 months predicted lower psychosocial HRQOL at 3 and 12 months after injury. Reliable increases in somatic symptoms at 3 month after injury predicted an increased rate of educational intervention.