Outcomes from mild and moderate traumatic brain injuries among children and adolescents: A systematic review of studies from 2008–2013

Abstract

Aim: To systematically review existing empirical evidence concerning neuropsychological, psychosocial and academic outcomes following mild and moderate TBI during childhood and adolescence.

Method: The studies reviewed include data on 8553 children and adolescents from ages 0–18 that experienced mild and moderate TBIs. A literature search using MeSH terms for ‘children’ cross-referenced with terms associated with ‘head injuries’ and ‘cognition’ was conducted using Pubmed, CINAHL Plus and Scopus databases as well as other data sources to retrieve grey literature results. Articles published between 1 January 2008 and 22 April 2013 were included.

Results: Fifty-five studies were included in the review, with multiple studies including information on both mild and moderate TBI; 46 studies focused on mild TBI outcomes and 22 studies focused on moderate TBI outcomes. The majority of outcomes were described as psychosocial (50%) or neuropsychological (40%); 51% of studies presented adverse outcomes.

Conclusions: The results suggest that not all children with mild or moderate TBI recover without long-term problems. Few studies followed children and adolescents with mild TBIs for extended periods of time, although it is clinically important to monitor patients over time.

• Head injury
• mild brain injury
• traumatic brain injury

Acknowledgements

JL and MW screened, reviewed and analysed relevant literature for inclusion, drafted the first version of the manuscript and revised it in consultation with co-authors. OT and SS participated in the planning of the study and critically reviewed the manuscript for relevant clinical and scientific content. All authors approved the final version of the manuscript.

Declaration of interest

MW’s participation was funded by a grant from Suomen Kulttuurirahsto (Helsinki, Finland). The funding agency had no role in the design of the study or in the interpretation of the results. The other authors report no conflicts of interest.

Supplementary material available online

Provided in the online Web Appendix