Published online June 22, 2007
PEDIATRICS Vol. 119 No. 3 March 2007, pp. e616-e623 (doi:10.1542/peds.2006-2313)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Keenan, H. T.
Right arrow Articles by Runyan, D. K.
Right arrow Search for Related Content
PubMed
Right arrow Articles by Keenan, H. T.
Right arrow Articles by Runyan, D. K.
Related Collections
Right arrow Office Practice

ARTICLE

Neurodevelopmental Consequences of Early Traumatic Brain Injury in 3-Year-Old Children

Heather T. Keenan, MDCM, PhDa, Stephen R. Hooper, PhDb, Crista E. Wetherington, PhDc, Maryalice Nocera, MSNd and Desmond K. Runyan, MD, DrPHe

a Department of Pediatrics, University of Utah, Salt Lake City, Utah
b Clinical Center for the Study of Development and Learning, Department of Psychiatry
c School of Education
d University of North Carolina Injury Prevention Research Center
e Departments of Social Medicine and Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

OBJECTIVES. The purpose of this work was to determine cognitive and adaptive behavioral outcomes of children with traumatic brain injury acquired before age 2 years and to compare outcomes between inflicted versus noninflicted brain injury.

PATIENTS AND METHODS. All North Carolina children hospitalized in an ICU for a traumatic brain injury before age 2 years between the years 2000 and 2001 were eligible for study entry. A total of 112 surviving children were prospectively identified, 52 (46%) of whom had complete follow-up. Thirty-one control children were recruited from preschool settings. Control subjects were chosen to be demographically similar to case subjects. Child measures of cognition and adaptive behavior at age 3 years were measured and compared between children with and without traumatic brain injury and children with inflicted and noninflicted traumatic brain injury.

RESULTS. Sixty percent of injured children were >1 SD below normal on cognitive testing. Forty percent of injured children scored >1 SD below normal on adaptive behavior testing. Children with inflicted traumatic brain injury performed more poorly on tests of cognition and adaptive behavior. Glasgow Coma Scale ≥13, absence of seizures, income above twice the poverty guidelines, and high social capital were associated with improved outcomes. Injured children had lower scores than uninjured control children after adjustment for socioeconomic status.

CONCLUSIONS. Very young children with mild-to-severe traumatic brain injury as measured by the Glasgow Coma Scale are at risk for global cognitive deficits more than a year after the time of injury. Inflicted brain injury is associated with more severe injury and worse outcomes. This is less optimistic than findings in this same cohort 1 year after injury. Family characteristics seem to play a role in recovery after injury.

Key Words: abuse • traumatic brain injury • shaken baby syndrome • injury • developmental disabilities

Abbreviations: TBI—traumatic brain injury • SIB-R—Scales of Independent Behavior-Revised • GCS—Glasgow Coma Scale • RR—relative risk • CI—confidence interval • IQR—interquartile range • OR—odds ratio

Accepted Sep 27, 2006.




This article has been cited by other articles:


Home page
 AAP Grand RoundsHome page
S. L. Bratton
Neurodevelopmental Outcomes Following Traumatic Brain Injury
AAP Grand Rounds, June 1, 2007; 17(6): 62 - 63.
[Full Text] [PDF]