Evaluation of a follow-up program for mild traumatic brain injury in schoolchildren
R Nowacki1, N van Eldik1, M Eikens2
1Maastricht University Medical Centre+, PO-box 5800, 6202 AZ Maastricht, The Netherlands.
Insights
A follow-up program for children with mild traumatic brain injury (mTBI) identified persistent post-concussive symptoms in 19% of cases. Early intervention and education effectively resolved these issues, highlighting the importance of structured care pathways.
Area of Science:
- Pediatric Neurology
- Traumatology
- Public Health
Background:
- Mild traumatic brain injury (mTBI) is frequent in children, with potential for persistent post-concussive symptoms impacting daily life.
- Lack of established follow-up guidelines can delay appropriate medical care for affected children.
- A dedicated follow-up program was developed to screen for and address persistent symptoms.
Purpose of the Study:
- To implement and evaluate a follow-up program for children aged 4-18 years who sustained a mild traumatic brain injury.
- To identify the prevalence and nature of persistent post-concussive symptoms.
- To assess the effectiveness of early intervention and referral for specialized care.
Main Methods:
- A prospective follow-up program involving 305 children (aged 4-18) post-mTBI from July 2010 to December 2013.
- Utilized phone calls at 6 weeks and questionnaires for parents and teachers at 3 months to assess symptoms.
- Monthly multidisciplinary team discussions reviewed results and determined patient referrals.
Main Results:
- Headache was the most common initial symptom (63%).
- 19% of children experienced persistent problems at 6 weeks or 3 months, with 14% requiring referral.
- Common persistent symptoms included headache (32%), cognitive (23%), and behavioral problems (16%).
Conclusions:
- Approximately one-fifth of children experience post-concussive symptoms after mTBI.
- Patient/caregiver education and timely follow-up visits are crucial for early intervention.
- The implemented program successfully minimized physical and mental problems, with all issues resolved within two years.
Introduction:
Mild traumatic brain injury is a common condition in childhood. Although classified as mild, post-concussive symptoms may persist and interfere with daily activities. Because no established guidelines exist with respect to follow-up medical care for these children, there may be a delay in receiving appropriate care. We developed a follow up program to screen for persistent symptoms and if necessary, refer patients for further medical assistance.
Methods:
From July 2010 until December 2013, eligible children aged 4-18 years who presented after sustaining a mild traumatic brain injury were included. All patients received a phone call after 6 weeks. After a period of 3 months, both their schoolteacher and parents were asked to complete in a questionnaire. The results were discussed monthly by a multidisciplinary team.
Results:
A total of 305 children were enrolled in our follow-up program. Headache was the most common acute symptom upon presentation (63%). Overall, 19% of all patients had problems, either at 6 weeks or 3 months. 14% of these patients were referred for special care. Most common persistent post-concussive symptoms were headache (32%), cognitive problems (23%) and behavioural problems (16%). After a period of two years, a review of patient charts revealed that all of the problems were resolved.
Conclusion:
One fifth of the children exhibit post-concussive symptoms after mild traumatic brain injury. Education of patients and caregivers and a follow up visit if needed applied appropriate care at an early stage to minimise physical and mental problems.
