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Investigations on Alterations of Hippocampal Circuit Function Following Mild Traumatic Brain Injury
Published on: November 19, 2012
Neuropsychological and neuropsychiatric recovery from mild traumatic brain injury
Kathryn A Ritchie1,2, Beth S Slomine1,2
1Kennedy Krieger Institute.
Insights
Most children recover from mild traumatic brain injury (mTBI) within a month, but 10-30% face prolonged symptoms. Pre-injury mental health and family factors can predict longer recovery times in pediatric mTBI.
Area of Science:
- Pediatric neurology
- Neuroscience
- Public health
Background:
- Mild traumatic brain injury (mTBI) is a significant public health issue in children.
- While most children recover within a month, a substantial percentage experience persistent symptoms.
Purpose of the Study:
- To review recent literature on pediatric mTBI.
- To identify early symptoms, outcomes, and predictors of prolonged recovery.
- To discuss evidence-based assessment and treatment recommendations.
Main Methods:
- Literature review of recent studies on pediatric mTBI.
- Analysis of early symptoms, neuropsychiatric, and neuropsychological outcomes.
- Identification of factors associated with prolonged recovery.
Main Results:
- 10-30% of children have lingering symptoms beyond 3 months post-mTBI.
- Emotional and behavioral symptoms are common in prolonged recovery.
- Preinjury mental health, female sex, and family characteristics are linked to increased risk.
Conclusions:
- A minority of children experience prolonged mTBI-related concerns.
- Understanding and management strategies are evolving, but gaps remain.
- Active recovery models show promise for managing persistent symptoms.
Purpose Of Review:
Mild traumatic brain injury (mTBI) is a significant public health concern for children. This review summarizes recent literature on early symptoms and neuropsychiatric and neuropsychological outcomes following pediatric mTBI and highlights factors that predict prolonged recovery. Evidence-based recommendations for assessment and treatment are also discussed.
Recent Findings:
Whereas most children recover within 1 month after mTBI, 10-30% of children experience lingering neuropsychiatric or neuropsychological symptoms 3 months or more after injury. For the subset who experience prolonged recovery, new or worsening emotional and behavioral symptoms are the most frequent concerns. Recent research has suggested that specific factors, including preinjury mental health concerns, female sex, and family characteristics, are associated with increased risk of experiencing prolonged recovery. Early management includes reassurance, brief rest (1-3 days), and gradual return to typical activities. When symptoms linger for more than 4 weeks, evaluation in a specialty clinic is recommended and multimodal therapies are considered. Active recovery models, which include gradual return to aerobic exercise and cognitive behavioral approaches, are promising for the management of prolonged symptoms.
Summary:
A minority of children with mTBI experience prolonged neuropsychiatric or neuropsychological concerns. While our understanding of pediatric mTBI is growing, and recommendations for assessment and management have been developed, many gaps remain.
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