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A Pediatric Concussion Model in Mice: Closed Head Injury with Long-Term Disorders (CHILD)
Published on: February 7, 2025
Quality of life in children after mild head injury
Virginia Rotarescu1, A V Ciurea
1Neurosurgical Department, Clinical Hospital "Bagdasar - Arseni", "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Insights
Mild Head Injury (MHI) in children can lead to significant cognitive and behavioral issues, impacting quality of life. Comprehensive neurosurgical and neuropsychological evaluation is crucial for early detection and management of potential long-term effects.
Area of Science:
- Pediatric Neurology
- Neurotraumatology
- Child Psychology
Background:
- Mild Head Injury (MHI) in children presents challenges beyond immediate impairment.
- Assessing disability, handicap, and quality of life (QOL) is essential for a holistic understanding of MHI's impact.
Purpose of the Study:
- To evaluate the multifaceted effects of Mild Head Injury (MHI) in pediatric patients.
- To assess impairment, disability, handicap, and quality of life (QOL) following MHI in children.
Main Methods:
- A cohort of 1,319 children with MHI was analyzed, with 528 admitted based on risk factors.
- Patients underwent neurosurgical evaluation and 12-month follow-up.
- Neuropsychological testing was conducted to assess cognitive, emotional, and behavioral deficits.
Main Results:
- Falls were the most common cause of MHI (30.6%).
- Abnormal CT scans and surgical necessity were relatively low (19.8% and 5.5%, respectively).
- Post-concussion syndrome (PCS) affected 26.9% of cases, with cognitive dysfunctions (processing speed, memory, attention) being prominent.
Conclusions:
- Complete neurosurgical evaluation, including physical, neuro-radiological, and neuropsychological assessments, is recommended for children with MHI.
- Psychotherapy may benefit children experiencing MHI.
- MHI can harbor subtle lesions with potential delayed consequences requiring vigilant monitoring.
Introduction:
The study was conducted to evaluate the effects of Mild Head Injury (MHI) in children not only in terms of impairment, but also in terms of disability, handicap and quality of life (QOL).
Context:
Emergency Clinical Hospital "Bagdasar-Arseni", Bucharest, Romania, between 2000 and 2004
Methods:
We take into account the patients with mild head injury MHI (CCS of 14 and 15 and amnesia). From a cohort of 1,319 children, consecutive patients with MHI, presented at the emergency room in a period of four years (2000-2003), 528 children (40.0%) were selected for admission, based on the presence of the risk factors. All admitted patients were investigated based on a protocol of neurosurgical evaluation and were followed for a period of 12 months.
Results:
The Falls were the most common cause of MHI (30.6% - 162 cases). The proportion of children with detectable CT scan abnormalities was smaller (19.8% - 105 cases) and surgery was necessary in only 5.5% (29 cases). Special attention was paid to child-abuse and traffic accident cases. Post-concussion syndrome (PCS) was observed in 26.9% cases. Neuropsychological tests were performed in 96 children (21.2%), to evaluate neuropsychological, emotional, psychosocial and behavioral impairments. The study has shown that cognitive dysfunctions mainly were observed after MHI (especially deficits in information processing speed, memory and attention).
Conclusions:
The neurosurgeon should perform a complete evaluation of the children-patient with MHI, including a current physical examination, a neuro-radiological evaluation and a formal neuropsychological assessment, in order to detect the abnormalities and to treat them. Psychotherapy can be of benefit in cases with MHI. Any common case of MHI may hide a possible lesion with delayed consequences.
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