Pediatric Mild Head Injury: Definition and Consequences

儿科轻度头部受伤：定义和后果

• 批准号: 6862523
• 负责人: Ronald Maio
• 金额: $ 9.94万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-08-01 至 2006-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6862523
• 关键词: adolescence (12-20); brain injury; child (0-11); child behavior; child psychology; clinical research; emergency health services; functional ability; human morbidity; human subject; longitudinal human study; neuropsychological tests; patient oriented research; pediatrics; questionnaires; sign /symptom; trauma

More than 1 million children in the United States sustain traumatic brain injury each year. Approximately 90% of pediatric brain injuries are described as mild, yet mild traumatic brain injury(MTBI) research is plagued by problems of classification, measurement,and generalizability. This prospective, longitudinal study wil lseek to define pediatric MTBI according to empirically supportable criteria, measure cognitive and psychological sequelae on multiple occasions, and account for the contribution of premorbid characteristics to the symptoms experienced by children postinjury. Fifty children ages 10-17with MTBI, treated in the emergency department(ED) but not hospitalized, will be recruited. MTBI will be defined by blunt trauma or acceleration deceleration injury to the head followed by any combination of brief loss of consciousness(<30 min.), brief post-traumatic amnesia (<24 hours),alteration in mental state at the time of the accident, and neurological deficits that may be transient. Glasgow Coma Scale scores will be 13-15 with no intracranial pathology on any neuroimaging studies. Fifty control children with comparably severe injuries not involving the head will be recruited in the ED. Relevant historical and demographic information will be obtained. Pre-injury psychological, behavioral, and executive functioning will be assessed via parent checklists. Neurocognitive functioning wil lbe measured with instruments known to be sensitive to brain injury. Post-concussion symptoms(PCS) wil lbe assessed via a questionnaire.The assessments will occur in the ED, one week later,and one month thereafter.The MTBI group is expected to demonstrate more PCS and neurocognitive deficits than controls immediately post-injury and at the one-week follow-up point.Consideringpriorfindings, it is not clear whether the MTBI group will have more PCS and neurocognitive deficits 4-5 weeks post-injury. This study will contribute to the consistent definition of MTBI in children and set the stage for further investigations of the long-term consequences of head injury in children.

美国每年有超过 100 万儿童遭受创伤性脑损伤。大约 90% 的儿童脑损伤被描述为轻度，但轻度创伤性脑损伤 (MTBI) 研究受到分类、测量和概括性问题的困扰。这项前瞻性、纵向研究将寻求根据经验支持的标准来定义儿科 MTBI，在多个场合测量认知和心理后遗症，并解释病前特征对 MTBI 的影响。 儿童受伤后出现的症状。将招募 50 名 10-17 岁患有 MTBI 的儿童，他们在急诊室 (ED) 接受治疗但未住院。 MTBI 的定义是头部受到钝性创伤或加速减速损伤，随后出现短暂意识丧失（<30 分钟）、短暂创伤后遗忘（<24 小时）、受伤时精神状态改变的任意组合。事故和可能是暂时的神经功能缺损。格拉斯哥昏迷量表评分为 13-15，任何神经影像学研究均未发现颅内病理。 急诊科将招募 50 名患有非头部严重损伤的对照儿童。将获得相关的历史和人口统计信息。将通过家长检查表评估受伤前的心理、行为和执行功能。神经认知 将使用已知对脑损伤敏感的仪器来测量功能。将通过问卷评估脑震荡后症状 (PCS)。评估将在一周后和一个月后在急诊室进行。预计 MTBI 组在受伤后立即表现出比对照组更多的 PCS 和神经认知缺陷在一周的随访点。考虑到先前的发现，尚不清楚 MTBI 组是否会在 4-5 周内出现更多的 PCS 和神经认知缺陷受伤后。这项研究将有助于儿童 MTBI 的一致定义，并为进一步调查儿童头部损伤的长期后果奠定基础。