Memory functioning during the first year after closed head injury in children and adolescents

Effects of the severity of closed head injury (CHI) on verbal learning and memory and visual recognition memory were studied at base line and on a 1-year follow-up examination in 58 pediatric admissions sampled from three age ranges, 6-8, 9-12, and 13-15 years. Within each age range, recovery of memory was compared in patients with mild to moderate CHI and survivors of severe injury. Consistent with previous findings obtained in head-injured children sampled from a wide age range, the present study confirms that memory deficit persists at least 1 year after severe CHI. Impairment of visual recognition memory was directly related to severity of CHI in all three age ranges. The severity of CHI was directly related to initial and residual verbal memory deficit in adolescents, but this effect was inconsistent in children. We suggest that the cerebral substrate for visual recognition memory was well established in all three age ranges and thus was vulnerable to the effects of injury. In contrast, verbal memory skills were undergoing rapid development in the adolescents, but were still immature in children. Extended follow-up could conceivably demonstrate the late appearance of verbal memory deficit in the children who had apparent sparing of function.