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Post-concussive Signs and Symptoms in Preschool Children: A Systematic Review
Joy Noelle Yumul1,2, Louise Crowe3,4,5, Cathy Catroppa3,4,5,6
1Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia. joynoelle.yumul@mcri.edu.au.
Insights
Mild traumatic brain injury (mTBI) in young children often leads to similar post-concussive symptoms (PCS) as in older groups. However, data on PCS presentation and progression in preschoolers remains limited, impacting management strategies.
Area of Science:
- Pediatric neurology
- Neuroscience
- Child psychology
Background:
- Mild traumatic brain injury (mTBI) is prevalent in children under five.
- Understanding post-concussive signs and symptoms (PCS) in this age group is limited.
Purpose of the Study:
- To identify PCS in preschool children up to 12 months post-mTBI.
- To review data reporting methods for PCS in this population.
- To explore rates, progression, and predictors of PCS.
Main Methods:
- Systematic review of 11 studies meeting inclusion criteria.
- Searched databases including Ovid MEDLINE, EMBASE, PsycInfo, PubMed, and Scopus.
- Data extracted on PCS, duration of post-traumatic amnesia, and informant methods (parent interviews/questionnaires).
Main Results:
- Preschoolers exhibit PCS similar to other age groups post-mTBI.
- Average post-traumatic amnesia duration was approximately one day.
- Mood and behavioral changes were noted during recovery.
- Parents were the primary data informants.
Conclusions:
- Significant gaps exist in empirical data on PCS presentation and progression in preschoolers.
- Evidence for optimal management of PCS in this pediatric population is lacking.
- Further research is needed to address these data deficiencies.
Abstract:
Mild traumatic brain injury (mTBI) is common in children aged < 5 years, however, less is known about their experience of post-concussive signs and symptoms. This systematic review aims to identify post-concussive signs and symptoms experienced by preschool children up to 12 months post-injury, and to review the methods used to report this data. Relevant findings, including rates, progression, and possible predictors of post-concussive signs and symptoms were also identified. Databases (Ovid MEDLINE, EMBASE, PsycInfo, PubMed, Scopus) and reference lists were searched for relevant articles, which were screened based on specified criteria. Eleven articles met the inclusion criteria, being original studies published in English and presenting data on post-concussive signs and symptoms specific to preschool children with mTBI. Most reviewed studies investigated acute presentations of mTBI, and identified that preschool children demonstrate post-concussive symptoms (PCS) similar to other age groups. Post-traumatic amnesia duration of approximately one day was reported in preschool children following mTBI, as were changes in mood and behavior during the recovery period. Parents were the main informants, with data obtained through either interview or questionnaire. Review findings highlight the lack of empirical data regarding the presentation and progression of PCS in preschoolers following mTBI and evidence on how to best manage this group during recovery.
