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Postconcussion Syndrome in Children

This study evaluated 65 head injury pediatric patients six weeks postinjury. The authors sought the child's subjective appraisal of symptoms and compared them to orthopedic injury patients of the same age and demographic. Pediatric head trauma patients reported more symptoms than the orthopedic injury controls.

The researchers evaluated the patients' symptoms on the diagnostic criteria for (adult) postconcussion syndrome. 39% of the head injury group met the criteria compared to 2% of the orthopedic sample. The researchers concluded that postconcussion syndrome does occur in children for both mild and moderate-to-severe head traumas. The pediatric symptoms were consistent with those found in adults:

"Direct comparisons between adults and children matched for injury severity and chronicity in this study showed no differences in the reported number of symptoms following moderate-to-severe head trauma."

The study also found that anxiety contributes to the severity of symptoms. Anxious children had a significantly higher incidence of the other symptoms than children without anxiety. The source of stress may be parental over-concern, cerebral dysfunction, or the child's reaction to injury. The authors suggest that, like adults, the symptoms at 6 weeks may have both neurological and psychological components, and that both should be evaluated.

Mittenberg W, Wittner MS, Miller LJ. Postconcussion syndrome occurs in children. Neuropsychology 1997;11(3):447-452.