Citation

Anderson V, Godfrey C, Rosenfeld JV, Catroppa C. J. Neurotrauma 2012; 29(1): 143-153.

Affiliation

Murdoch Childrens Research Institute, Critical Care & Neuroscience, Royal Children's Hospital, Flemington Rd, Parkville, Victoria, Australia, 3052; vicki.anderson@rch.org.au.

Copyright

(Copyright © 2012, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2011.2012

PMID

22022835

Abstract

Objectives. Long-term consequences of child traumatic brain injury (TBI) are poorly understood, with some suggestion of ongoing deterioration in skills with time since injury. This study investigated outcomes to 10 years post-injury, to determine the influences of injury severity, injury age and environment. Design. Consecutive recruitment to a prospective, longitudinal study, with injury severity, injury age and time since injury as independent variables. Setting. Royal Children's Hospital, Melbourne, an tertiary pediatric hospital. Participants. Children sustaining TBI between 2 and 12 years (n=76) were recruited on admission and divided according to injury severity (mild, moderate, severe) and injury age (2-7 years, 8-12 years). Outcome measures. Cognitive abilities were evaluated using standard measures of intellectual function (IQ) acutely and at 12 months, 30 months and 10 years post-injury. Results. At 10 years, mean IQs for survivors fell within the low average to average ranges. There were no significant effects of injury severity, injury age or time since injury. In contrast, elevated rates of impairment were identified in association with severe TBI (global deficits) and early injury (non-verbal deficits). Impairments in processing speed were related to injury severity and age at injury. Predictors of 10-year outcome included pre-injury and social factors, injury age and family function. Conclusions. Child survivors of serious TBI are at elevated risk of cognitive impairment, with recovery continuing into the third year post-injury. However, between 30 months and 10 years post-insult, children appear to make appropriate developmental gains, contrary to the speculation that these children 'grow into their deficits'.

Language: en