Murdoch Children's Research Institute, Melbourne, Australia.
University of Melbourne, Melbourne, Australia.
Dev Neurorehabil. 2023 Jul;26(5):338-347. doi: 10.1080/17518423.2023.2242945. Epub 2023 Aug 7.
Post-concussive symptoms (PCS) are central to the assessment and management of mild traumatic brain injury (mTBI); however, this remains poorly understood in children aged ≤5 years. The study aimed to explore individual PCS, pattern of parents' PCS report over time, proportion of symptomatic children, and variables associated with parents' report of PCS in their preschool child after a mTBI.
Children aged 2-5 years with either a mTBI (n=13) or limb injury (n=6) were recruited from the emergency department (ED). Parent ratings of child PCS were assessed at ED presentation, at one month, and at three months post-injury. Injury (e.g. injury group, pain), child (e.g. pre-existing behavior, symptoms), and parent (e.g. parental stress, education) characteristics were considered when investigating variables that may be relevant to parent report of PCS.
The number of total, physical, and sleep PCS were significantly higher after mTBI, with a significant decrease in physical and sleep PCS over time. The proportion of symptomatic children was comparable between injury groups at each time point. Acute pain and pre-injury symptoms were significantly associated with parents' acute PCS report in the mTBI group. Further research is needed on variables that may be relevant to parents' PCS report at follow-up.
Preliminary findings suggest a general trauma response after a mTBI or limb injury, but acute physical and sleep PCS may help differentiate the injury groups. Injury and premorbid child variables may be relevant to parents' report of acute PCS in their child. Additional research is needed to investigate PCS in preschoolers and variables that may predict parents' PCS report.
脑震荡后症状(PCS)是评估和管理轻度创伤性脑损伤(mTBI)的核心;然而,这在≤5 岁的儿童中仍未得到很好的理解。本研究旨在探讨单个 PCS、父母随时间报告 PCS 的模式、有症状儿童的比例以及与 mTBI 后学龄前儿童父母报告 PCS 相关的变量。
从急诊科招募了 2-5 岁的 mTBI(n=13)或肢体损伤(n=6)儿童。在急诊科就诊时、受伤后一个月和三个月时,家长对儿童 PCS 进行了评分。在调查可能与父母报告 PCS 相关的变量时,考虑了损伤(例如损伤组、疼痛)、儿童(例如预先存在的行为、症状)和父母(例如父母压力、教育)特征。
mTBI 后,总、躯体和睡眠 PCS 的数量明显更高,躯体和睡眠 PCS 随时间显著下降。在每个时间点,损伤组的有症状儿童比例相似。急性疼痛和受伤前症状与 mTBI 组父母的急性 PCS 报告显著相关。需要进一步研究与父母随访时 PCS 报告相关的变量。
初步研究结果表明 mTBI 或肢体损伤后存在一般的创伤反应,但急性躯体和睡眠 PCS 可能有助于区分损伤组。损伤和受伤前儿童变量可能与父母对其子女急性 PCS 的报告相关。需要进一步研究学龄前儿童的 PCS 以及可能预测父母 PCS 报告的变量。