Prolonged injury symptoms and later visits to psychiatric care after mild traumatic brain injury in school-age

ABSTRACT

Objective

To investigate demographic and pre-injury factors in Finnish school-aged children admitted to pediatric neurology services after mild traumatic brain injury (mTBI). The relation of these factors to prolonged injury symptoms and later visits into psychiatric care was assessed.

Methods

Demographic information, pre-injury learning status, and neuropsychological test results of 120 patients aged 7–16 years were retrospectively collected from the hospital medical records. Data were compared with self- or parent-reported injury symptoms at 1–3 months post-injury and later visits to psychiatric care.

Results

According to medical records, 14.2% of the children with mTBI had a diagnosed neurobehavioral or psychiatric condition pre-injury. Additionally, 53.3% of the children had some neurobehavioral or psychiatric concerns or traits prior to the injury. Over half (56.7%) of the children studied were symptomatic at 1–3 months following the injury. Female gender and presence of prolonged symptoms were predictive for later visit into psychiatric care.

Conclusions

Pre-injury neurobehavioral or psychiatric problems may predict prolonged injury symptoms following pediatric mTBI. In this retrospective patient series, prolonged symptoms and female gender seem to predict the need for later psychiatric care. Monitoring the recovery of children with mTBI and pre-injury risk factors is important for timely interventions.

KEYWORDS:

• Mild traumatic brain injury
• pediatric
• pre-injury learning
• psychiatric care

Acknowledgments

This study was supported by the Turku University Foundation under grant number 11-211 and the Finnish Cultural foundation under grant number 00190926.

Author biography

Mari Saarinen, Lic.Psych., is a clinical neuropsychologist and PhD student with her main research interest being in pediatric traumatic brain injury. As a clinician she has more than 15 years of experience in rehabilitation of children and youth with TBI along with holistic pediatric rehabilitation program.

Nina Erkinjuntti, MD, is specialising physician for Pediatric Neurology at Turku University and her current position is at Turku University Hospital, Department of Pediatric neurology. She is also a PhD-student at Turku University. Her main research interest is traumatic brain injury in children and adolescents.

Sanna Koskinen, PhD, is a clinical neuropsychologist, university lecturer, and researcher. Her current position is at the University of Helsinki. Her main research interests focus on traumatic brain injury. She has more than 30 years of clinical experience with neurological patients. Her main clinical interests are in the field of rehabilitation, especially with persons with TBI and stroke. Her most recent focus of interest is on cognitive recovery after COVID-19 (RECOVID-20).

Leena Himanen, PhD, is a qualified neuropsychologist with particular interest in long term outcome after TBI, behavioral brain imaging and neuropsychiatry of TBI.

Tero Vahlberg, M.Sc., is biostatistician and his current position is at Turku University, Department of Biostatistics. He has been as a co-author in more than 350 articles published in medical journals.

Olli Tenovuo is a Professor of Neurotraumatology at the University of Turku, Finland and leads The Turku Brain Injury Center, Division of Clinical Neurosciences, Turku University Hospital. He does research in all fields of traumatic brain injury, and most new projects focus on new diagnostic biomarkers and imaging modalities in patients with head injuries.

Tuire Lähdesmäki is a senior pediatric neurologists and a head of Pediatric Neurology Department at Turku University Hospital, Turku, Finland. She also works as a clinical lecturer of Pediatric Neurology at the University of Turku. Her scientific work concentrates on the effects of childhood brain events (infectious, immunological, oncological or traumatic) on the neurological long term outcome and quality of life.

Declarations of interests

The authors report no conflict of interest. The authors alone are responsible for the content and writing of the paper.

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.

Additional information

Funding

This work was supported by the Turku University Foundation [11-211] and Finnish Cultural foundation [00190926].