With the aim of determining long-term outcome, the authors approached 38 families (average 2.1 years after trauma) with a questionnaire, following the acute-clinical treatment of head trauma of their children. Long-term damage was restricted almost exclusively to patients presenting with a Glasgow Coma Score ≤8. Paresis (16%), cranial nerve damage (13%), incontinence (5%), or coordinative disturbances (18%) continued. The older children stated that they influenced their life to a great extent (11%). Furthermore, many had mental and cognitive problems that occur quite frequently even in children with light head trauma and often only manifest after release from hospital. This causes problems and results in inferior performance (26%), especially at school, which is further complicated through lengthy periods of absence. The parents, especially, mentioned behavioral problems such as social withdrawal or aggressive demeanor, which led to tension also inside the family. A persistent vegetative state is rare after head trauma in children.
Jaffe KM, Polissar NL, Fay GC, Liao S.Recovery trends over three years following pediatric traumatic brain injury . Arch Phys Med Rehabil. 1995;76(1):17-26.
2.
Williams DH, Levin HS, Eisenberg HMMild head injury classification. Neurosurgery. 1990;27(3):422-428.
3.
Levin HS, Hanten G., Zhang L., et al. Changes in working memory after traumatic brain injury in children . Neuropsychology. 2004; 18(2):240-247.
4.
Brookshire B. , Levin HS, Song J., Zhang L.Components of executive function in typically developing and head-injured children. Dev Neuropsychol. 2004;25(1-2):61-83.
5.
Hanten G., Wilde EA, Menefee DS, et al. Correlates of social problem solving during the first year after traumatic brain injury in children. Neuropsychology. 2008;22(3):357-370.
6.
Anderson VA, Catroppa C., Haritou F., et al. Predictors of acute child and family outcome following traumatic brain injury in children. Pediatr Neurosurg. 2001;34(3):138-148.
7.
Eslinger PJ, Biddle KRAdolescent neuropsychological development after early right prefrontal cortex damage. Dev Neuropsychol. 2000;18(3):297-329.
8.
Stuss DT, Anderson V.The frontal lobes and theory of mind: developmental concepts from adult focal lesion research. Brain Cogn. 2004 ;55(1):69-83.
9.
Goldstrohm SL , Arffa S.Preschool children with mild to moderate traumatic brain injury: an exploration of immediate and post-acute morbidity. Arch Clin Neuropsychol. 2005;20(6):675-695.
10.
Max JE, Roberts MA, Koele SL, et al. Cognitive outcome in children and adolescents following severe traumatic brain injury: influence of psychosocial, psychiatric, and injury-related variables. J Int Neuropsychol Soc. 1999;5(1):58-68.
11.
Max JE, Lansing AE, Koele SL, et al. Attention deficit hyperactivity disorder in children and adolescents following traumatic brain injury. Dev Neuropsychol. 2004;25(1-2):159-177.
12.
Taylor HG, Yeates KO, Wade SL, Drotar D., Stancin T., Minich N.A prospective study of short- and long-term outcomes after traumatic brain injury in children: behavior and achievement. Neuropsychology . 2002;16(1):15-27.
13.
Yeates KO, Taylor HG, Wade SL, et al. A prospective study of short- and long-term neuropsychological outcomes after traumatic brain injury in children. Neuropsychology . 2002;16(4):514-523.
14.
Dumas HM, Haley SM, Bedell GM, Hull EMSocial function changes in children and adolescents with acquired brain injury during inpatient rehabilitation. Pediatr Rehabil . 2001;4(4): 177-185.
15.
Yeates KO, Swift E., Taylor HG, et al. Short- and long-term social outcomes following pediatric traumatic brain injury. J Int Neuropsychol Soc. 2004 ;10(3):412-426.
16.
Rivara JB, Fay GC, Jaffe KM, Polissar NL, Shurtleff HA, Martin KMPredictors of family functioning one year following traumatic brain injury in children. Arch Phys Med Rehabil. 1992;73(10):899-910.
17.
Wade SL, Taylor HG, Drotar D., Stancin T., Yeates KOChildhood traumatic brain injury: initial impact on the family. J Learn Disabil. 1996;29(6):652-661.
18.
Berger-Gross P., Shackelford M.Closed-head injury in children: neuropsychological and scholastic outcomes. Percept Mot Skills . 1985;61(1):254.
19.
Catroppa C. , Anderson V.Recovery of educational skills following paediatric traumatic brain injury. Pediatr Rehabil . 1999 ; 3(4):167-175.
20.
Rivara JB, Jaffe KM, Fay GC, et al. Family functioning and injury severity as predictors of child functioning one year following traumatic brain injury. Arch Phys Med Rehabil. 1993;74(10): 1047-1055.
21.
Anderson V. , Catroppa C., Morse S., Haritou F., Rosenfeld J.Recovery of intellectual ability following traumatic brain injury in childhood: impact of injury severity and age at injury. Pediatr Neurosurg. 2000;32(6):282-290.
22.
Max JE, Koele SL, Castillo CC, et al. Personality change disorder in children and adolescents following traumatic brain injury. J Int Neuropsychol Soc. 2000;6(3):279-289.
23.
Catroppa C. , Anderson VA, Morse SA, Haritou F., Rosenfeld J.Outcome and predictors of functional recovery 5 years following pediatric traumatic brain injury (TBI). J Pediatr Psychol. 2008; 33(7):707-718.
24.
Webster G., Daisley A.Including children in family-focused acquired brain injury rehabilitation: a national survey of rehabilitation staff practice. Clin Rehabil . 2007;21(12):1097-1108.
25.
Braga LW, Da Paz AC, Ylvisaker M.Direct clinician-delivered versus indirect family-supported rehabilitation of children with traumatic brain injury: a randomized controlled trial. Brain Inj. 2005;19(10):819-831.
26.
Michaud LJ, Duhaime AC, Batshaw MLTraumatic brain injury in children. Pediatr Clin North Am . 1993;40(3):553-565.
27.
Beaulieu CLRehabilitation and outcome following pediatric traumatic brain injury. Surg Clin North Am. 2002;82(2):393-408.
28.
Prigatano G. , O’Brien K., Klonoff P.Neuropsychological rehabilitation of young adults who suffer brain injury in childhood: clinical observations. Neuropsychol Rehabil . 1993;3(4):411-421.
29.
Fletcher JM , Ewing-Cobbs L., Miner ME, Levin HS, Eisenberg HMBehavioral changes after closed head injury in children. J Consult Clin Psychol. 1990;58(1):93-98.
30.
Rutter M.Psychological sequelae of brain damage in children. Am J Psychiatry . 1981;138(12):1533-1544.
31.
Bohnert A., Parker J., Warschausky S.Friendship and social adjustment of children following a traumatic brain injury: an exploratory investigation. Dev Neuropsychol . 1997;13(4):477-486.
32.
Scarr S., Weinberg R., Levine A.Understanding Development. New York, NY: Harcourt Brace Jovanovich; 1986.
33.
Kapapa T., König K., Pfister U., et al. Head trauma in children, part 1: admission diagnostics and findings . J Child Neurol.2010; 25(2):146-156.
34.
Kapapa T., König K., Pfister U., et al. Head trauma in children, part 2: course and discharge with outcome . J Child Neurol.2010; 25(3):274-283.
35.
Jennett B., Bond M.Assessment of outcome after severe brain damage. Lancet. 1975;1(7905):480-484.
36.
Teasdale G. , Jennett B.Assessment of coma and impaired consciousness . A practical scale. Lancet. 1974;2(7872):81-84.
37.
Bullinger M. , Morfeld M., Kohlmann T., et al. SF-36 Health Survey in Rehabilitation Research. Findings from the North German Network for Rehabilitation Research, NVRF, within the rehabilitation research funding program [in German]. Rehabilitation ( Stuttg). 2003;42(4):218-225.
Chiaretti A. , Piastra M., Pulitanò S., et al. Prognostic factors and outcome of children with severe head injury: an 8-year experience . Childs Nerv Syst. 2002;18(3-4):129-136.
40.
Drommer S.Untersuchungen zum schweren Schädel-Hirn-Trauma bei Kindern. Hannover, Germany: Medizinische Hochschule Hannover ; 1999.
41.
Catroppa C. , Anderson V., Stargatt R.A prospective analysis of the recovery of attention following pediatric head injury. J Int Neuropsychol Soc. 1999;5(1):48-57.
42.
Klonoff H., Clark C., Klonoff PSLong-term outcome of head injuries: a 23 year follow up study of children with head injuries. J Neurol Neurosurg Psychiatry. 1993;56(4):410-415.
43.
Jacobi G., Klinter D., Weiermann G.Clinical picture and pathophysiology of elevated intracranial pressure [in German]. Klin Padiatr. 1988;200(5):359-374.
44.
Fiser DHAssessing the outcome of pediatric intensive care. J Pediatr . 1992;121(1):68-74.
45.
Keenan HT, Runyan DK, Nocera M.Longitudinal follow-up of families and young children with traumatic brain injury. Pediatrics. 2006;117(4):1291-1297.
46.
Gobiet W.Effect of multiple trauma on rehabilitation of patients with craniocerebral injuries [in German]. Zentralbl Chir. 1995 ; 120(7):544-550.
47.
Hackbarth R. , Bunchman TE, Chua AN, et al. The effect of vascular access location and size on circuit survival in pediatric continuous renal replacement therapy: a report from the PPCRRT registry. Int J Artif Organs. 2007;30(12):1116-1121.
48.
Montgomery V., Oliver R., Reisner A., Fallat METhe effect of severe traumatic brain injury on the family. J Trauma. 2002; 52(6):1121-1124.
49.
Bullock MR, Merchant RE, Choi SC, et al. Outcome measures for clinical trials in neurotrauma. Neurosurg Focus. 2002;13(1): ECP1.
50.
Pfenninger J., Santi A.Severe traumatic brain injury in children- are the results improving? Swiss Med Wkly. 2002;132(9-10): 116-120.
51.
Eilander HJ , Timmerman RB, Scheirs JG, Van Heugten CM, De Kort PL, Prevo AJChildren and young adults in a prolonged unconscious state after severe brain injury: long-term functional outcome as measured by the DRS and the GOSE after early intensive neurorehabilitation. Brain Inj. 2007;21(1):53-61.
52.
Ruijs MB, Gabreëls FJ, Keyser A.The relation between neurological trauma parameters and long-term outcome in children with closed head injury. Eur J Pediatr . 1993;152(10):844-847.
53.
Keenan HT, Hooper SR, Wetherington CE, Nocera M., Runyan DKNeurodevelopmental consequences of early traumatic brain injury in 3-year-old children. Pediatrics. 2007; 119(3):e616-e623.
54.
Max JE, Lindgren SD, Knutson C., Pearson CS, Ihrig D., Welborn A.Child and adolescent traumatic brain injury: psychiatric findings from a paediatric outpatient specialty clinic. Brain Inj. 1997 ;11(10):699-711.
55.
Ravens-Sieberer U., Patrick PD, Benz B., et al. and CHI Consensus Group.Quality of life in children with traumatic brain injury- basic issues, assessment, and recommendations. Restor Neurol Neurosci. 2002;20(3-4):151-159.
56.
Bullinger M.Quality of life: definition, conceptualisation and implications-a methodologists view. Theor Surg. 1991;6: 143-149.
57.
Stewart AL, Ware JE Jr, Brook RHAdvances in the measurement of functional status: construction of aggregate indexes. Med Care. 1981;19(5):473-488.
58.
Kapapa T., König K., Heissler HE, et al. Health-related quality of life as amendment to clinical outcome in neurosurgery. Neurol Rehabil. 2006;12(1):37-41.
59.
Eiser C.Children’s quality of life measures. Arch Dis Child . 1997; 77(4):350-354.
60.
Eiser C., Jenney MEMeasuring symptomatic benefit and quality of life in paediatric oncology . Br J Cancer. 1996;73(11): 1313-1316.
61.
Juniper EF, Guyatt GH, Feeny DH, Ferrie PJ, Griffith LE, Townsend M.Measuring quality of life in the parents of children with asthma. Qual Life Res. 1996;5(1):27-34.
62.
Landgraf I., Abetz L., Ware J.Child Health Questionnaire (CHQ): A Users Manual. Boston, MA: The Health Institute Press; 1997.
63.
Verrips GH, Vogels AGC, Verloove-Vanhorick SP, Fekkes M., Koopman HM, Kamphuis RPHealth-related quality of life measure for children-the TACQOL. J Appl Ther. 1997;1: 357-360.
64.
Bruil J., Maes L., le Coq L., Boeke J.The development of the how are you (HAY), a quality of life questionnaire for children with a chronic illness. Qual Life Newslett. 1996;13:9.
65.
Simeoni MC, Auquier P., Antoniotti S., Sapin C., San Marco JLValidation of a French health-related quality of life instrument for adolescents: the VSP-A. Qual Life Res. 2000 ;9(4):393-403.
66.
Starfield B. , Riley A.Profiling Health and Illness in Children and Adolescents. Mahwah, NJ: Lawrence Erlbaum; 1998 .
67.
Bullinger M. , Mackensen S., Kirchberger I.KINDL-ein Fragebogen zur gesundheitsbezogenen Lebensqualität von Kindern. Zeitschr. Gesundheitspsychologie . 1994;2:64-67.
68.
Barry CT, Taylor HG, Klein S., Yeates KOThe validity of neurobehavioral symptoms reported in children after traumatic brain injury. Child Neuropsychol. 1996;2:213-226.
69.
Rivara JB, Jaffe KM, Polissar NL, et al. Family functioning and children’s academic performance and behavior problems in the year following traumatic brain injury. Arch Phys Med Rehabil. 1994;75(4):369-379.
70.
Yeates K., Taylor H., Barry C., Drotar D., Wade S., Stancin T.Neurobehavioral symptoms in childhood closed-head injuries: changes in prevalence and correlates during the first year postinjury. J Pediatr Psychol. 2001;26(2):79-91.
71.
Laatsch L., Harrington D., Hotz G., et al. An evidence-based review of cognitive and behavioral rehabilitation treatment studies in children with acquired brain injury. J Head Trauma Rehabil. 2007;22(4):248-256.
72.
Chadwick O. , Rutter M., Shaffer D., Shrout PEA prospective study of children with head injuries: IV. Specific cognitive deficits. J Clin Neuropsychol . 1981;3(2):101-120.
73.
Ewing-Cobbs L., Barnes M., Fletcher JM, Levin HS, Swank PR, Song J.Modeling of longitudinal academic achievement scores after pediatric traumatic brain injury. Dev Neuropsychol . 2004; 25(1-2):107-133.
74.
van Heugten CM, Hendriksen J., Rasquin S., Dijcks B., Jaeken D., Vles JHLong-term neuropsychological performance in a cohort of children and adolescents after severe paediatric traumatic brain injury. Brain Inj. 2006;20(9):895-903.
75.
Stanton BRDoes family functioning affect outcome in children with neurological disorders ? Pediatr Rehabil. 1999;3(4):193-199.
76.
Prigatano GPPrinciples of Neuropsychological Rehabilitation. New York, NY: Oxford University Press; 1999 .
77.
Dennis M., Guger S., Roncadin C., Barnes M., Schachar R.Attentional-inhibitory control and social-behavioral regulation after childhood closed head injury: do biological, developmental and recovery variables predict outcome?J Int Neuropsychol Soc. 2001 ;7(6):683-692.
78.
Papero PH, Prigatano GP, Snyder HM, Johnson D.Children’s adaptive behavioural competence after head injury . Neuropsychol Rehabil. 1993;3:321-340.
79.
Kozloff R.Network of social support and the outcome from severe head injury . J Head Trauma Rehabil. 1987;2(3):14-23.
80.
Nassau JH, Drotar D.Social competence among children with central nervous system-related chronic health conditions: a review. J Pediatr Psychol. 1997;22(6):771-793.
81.
Ylvisaker M. , Adelson PD, Braga LW, et al. Rehabilitation and ongoing support after pediatric TBI: twenty years of progress. J Head Trauma Rehabil. 2005;20(1):95-109.
82.
Prigatano GP , Gupta S.Friends after traumatic brain injury in children . J Head Trauma Rehabil. 2006 ;21(6):505-513.
83.
Max JE, Robin DA, Lindgren SD, et al. Traumatic brain injury in children and adolescents: psychiatric disorders at two years. J Am Acad Child Adolesc Psychiatry . 1997;36(9):1278-1285.
84.
Kinsella G. , Ong B., Murtagh D., Prior M., Sawyer M.The role of the family for behavioral outcome in children and adolescents following traumatic brain injury. J Consult Clin Psychol. 1999 ; 67(1):116-123.
85.
Anderson VA , Catroppa C., Haritou F., Morse S., Rosenfeld JVIdentifying factors contributing to child and family outcome 30 months after traumatic brain injury in children. J Neurol Neurosurg Psychiatry . 2005;76(3):401-408.
86.
Ganesalingam K., Yeates KO, Ginn MS, et al. Family burden and parental distress following mild traumatic brain injury in children and its relationship to post-concussive symptoms. J Pediatr Psychol . 2008;33(6):621-629.
87.
Brooks BM, Rose FD, Johnson DA, Andrews TK, Gulamali R.Support for children following traumatic brain injury: the views of educational psychologists. Disabil Rehabil. 2003;25(1):51-56.
88.
Sameroff AJEnvironmental risk factors in infancy. Pediatrics. 1998;102(5supplE):1287-1292.
89.
Ewing-Cobbs L., Prasad MR, Landry SH, Kramer L., DeLeon R.Executive functions following traumatic brain injury in young children: a preliminary analysis . Dev Neuropsychol . 2004;26(1): 487-512.
90.
Janusz JA, Kirkwood MW, Yeates K., Taylor HGSocial problem-solving skills in children with traumatic brain injury: long-term outcomes and prediction of social competence. Child Neuropsychol . 2002;8(3):179-194.
