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Advanced Neurology Cognition in children with mild TBI

Figure 1. Flowchart of the systematic review of literature
Abbreviation: mTBI: Mild traumatic brain injury
and higher SES. According to Murphy and Dodd, the height, and one child was struck on her head by a heavy
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association is not significant. 42 object. The median GCS at the time of the first neurological
evaluation was 14 (IQR, 13 – 15), and three patients were
3.1.4. Psychological intervention hospitalized in the intensive care unit because of the severity
Some studies have evaluated the impact of psychological of other traumatic injuries. Loss of consciousness (n = 7),
intervention in children with mTBI. 36,41 Shorer et al. headache (n = 5), vomiting (n = 5), posttraumatic amnesia
demonstrated that the patients’ emotional status and their (n = 5), and drowsiness (n = 5) were the most frequently
cognitive function improved after prolonged exposure to reported symptoms at the time of admission. The baseline
psychological support and that parental post-traumatic characteristics of the study patients are shown in Table 2.
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stress disorder was the strongest predictor of improvement.
Similarly, Connery et al. demonstrated that the identification 3.2.2. Head CT at the time of admission
and communication of invalid performance can promote All patients underwent a head CT within the first 24 h of
high levels of caregiver satisfaction and reduce self- and diagnosis (T0). In 10 patients, CT revealed a specific brain
caregiver-reported symptoms. 36 injury. In the remaining five patients, no parenchymal or
bone lesion was detected. A concomitant skull fracture was
3.2. Monocentric cohort study noted in eight patients, whereas a parenchymal lesion far

3.2.1. Patient characteristics from the direct site of impact was detected in four patients.
A brain MRI was also performed for two patients in the
During the study period, 892 children were evaluated at acute phase. MRI confirmed the injuries detected on CT.
our hospital for TBI. Of these children, 36 (4%) underwent The main findings of T0 neuroradiological examinations
a brain CT according to the PECARN criteria. Among are depicted in Figure 3.
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these patients, 11 were excluded because they did not
meet the inclusion criteria, and 10 were lost to follow-up 3.2.3. Neuropsychological assessment
(Figure 2). Thus, 15 patients (11 boys, 73%) with a median All children were evaluated using the NEPSY-II scale at T1
age of 9 (IQR, 5.5 – 14.0) years at the time of TBI were and T2. Comparisons between T1 and T2 data, including
included in the final study population. only attention and executive functioning as well as memory
Most of the patients (n = 10) were involved in a motor and learning domains, showed no significant differences
vehicle accident. Four children reportedly fell from a (Table 3).

Volume 3 Issue 4 (2024) 5 doi: 10.36922/an.3886