Rehabilitation and follow-up of children with severe traumatic brain injury.
We studied the outcome of 25 patients [12 girls and 13 boys; mean age 13.7 (SD 3.9 years)] with severe traumatic brain injury (TBI). The Glasgow Coma Scale (GCS) score 6 h after the injury was (mean) 4.5 (SD 2.7), and the mean duration of unconsciousness was 15.8 (SD 10.6) days. Being the most severely brain-injured children in the health care region, they were all referred to its only regional pediatric rehabilitation center during 1986-1990. At discharge, 1 patient was healthy, 1 was in a vegetative state and 18 had multiple impairments. Motor problems were present in 22, epilepsy in 7 and speech impairment in 14. It was not possible to assess cognition in 3 of the children, and 15 of the remaining 22 fell in the normal range. At follow up 2-6 years after trauma, all 23 survivors reported at least one sequela, and 21 had multiple sequelae. As many as two-thirds had normal I.Q. and only 3 were non-ambulatory, but behavioral and personality disturbances were so disabling that none of the patients in this group had been able to readjust to a normal life in society after the trauma.
Bräcke Ostergård Regional Pediatric Rehabilitation Center, Gothenburg, Sweden.
I
I
Emanuelson
L
L
von Wendt
E
E
Lundälv
J
J
Larsson
D000293:Adolescent; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D002648:Child; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology; D015600:Glasgow Coma Scale; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000534:rehabilitation*; D014950:Wounds, Penetrating / Q000534:rehabilitation*