Outcome 1 to 3 years after severe traumatic brain injury in children and adolescents.
This study reports a consecutive series of 220 children and adolescents who sustained traumatic brain injury (BI) and were admitted to a comprehensive paediatric rehabilitation programme. Progress in areas of mobility, activities of daily living, education and cognitive function were documented for up to 3 years after the injury. Physical recovery was most rapid in the first years and cognitive and language gains generally occurred later, even up to 3 years after the injury. Cognitive assessment at the time of admission proved helpful in predicting outcome; of those patients admitted in a conscious state only one remained dependent for any aspect of self care. Even for those admitted unconscious at a median of 62 days after injury there was good potential for recovery with 27-43 per cent achieving independence in the activities of daily living. For those still unconscious at 6 months, 72 per cent remained vegetative and none achieved the highest cognitive level. Overall, 14 per cent returned to regular education while 25 per cent remained incapable of any educational programme. In a well planned and multidisciplinary rehabilitation programme, patients with severe BI have potential for continued recovery and measurable improvement for at least 3 years. The emphasis should be targeted on differing areas of the therapy programme at different phases of recovery. A realistic appraisal of the ultimate potential for recovery can usually be made by 6 months.
Children's Specialized Hospital, Mountainside, New Jersey.
M G
MG
Boyer
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P
Edwards
D000063:Accidents, Traffic; D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D003142:Communication; D004493:Education; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D012737:Sex Factors; D016138:Walking