The prevalence, course and clinical features of post-concussion syndrome in children

Olga Nečajauskaitė, Milda Endzinienė¹, Kristina Jurėnienė²

Center of Pediatric Surgery, Vilnius University Children’s Hospital, ¹Clinic of Neurology, ²Department of Physics, Mathematics and Biophysics, Kaunas University of Medicine, Lithuania

Key words: mild traumatic brain injury, children, post-concussion syndrome.

Summary. Objective. To investigate the clinical features and the prevalence of symptoms of post-concussion syndrome in children with mild traumatic brain injury, and to evaluate their changes over time.

Material and methods. The research involved two groups of 4–16 year-old children: the case group of 301 children who had experienced a single mild traumatic brain injury, and the control group of 301 children who had sustained any other mild body injury without head trauma. Groups were matched according to gender, age, and the date of admission to hospital. In total, 102 matched pairs were analyzed. The period between the date of the trauma and the examination was one to five years (median – 27 months). Standartized questionnaires were sent by post to parents from both groups. Parents were asked about the health state as well as symptoms of post-concussion syndrome, their character and frequency. The respondents were inquired about the presence of the symptoms prior to the trauma, shortly after the trauma, and during the last year and the last month before the inquiry.

Results. The prevalence of headache, irritability, fears, sleep disorders, learning difficulties, as well as concentration and memory problems did not differ significantly between children with mild traumatic brain injury and the control group when the results of the last year before examination and the last month before the examination were compared. We have investigated how the period of time between the date of the trauma and the date when the questionnaire was filled in influenced the results. The comparison of the questionnaires that were filled a year (but less than two years) after the trauma to those that were filled in 2–5 years after the trauma revealed significant differences in the prevalence of a number of symptoms of the post-concussion syndrome. In children with mild traumatic brain injury, there was a significant decrease in the prevalence of learning difficulties soon after the trauma (p=0.032), headaches before (p=0.026) and soon after the trauma (p=0.01), and irritability the last month before the examination (p=0.043). In children from the control group, there was a significant decrease in the prevalence of concentration problems the last year before examination (p=0.023) and the last month before examination (p=0.036).

Conclusions. More than one year after the trauma, the prevalence of the symptoms of the post-concussion syndrome is not significant higher in children with mild traumatic brain injury, compared to children with other mild body injuries, and is comparable by the changes over time.

Correspondence to O. Nečajauskaitė, Center of Children Surgery, Children’s Hospital, Vilnius University, Santariškių 7, 08406 Vilnius, Lithuania. E-mail: olgutene@takas.lt

Received 8 November 2004, accepted 16 May 2005