title: Pediatric rehabilitation of severe acquired brain injury: a multicenter survey.
abstract: BACKGROUND
  Epidemiological and descriptive data concerning the clinical and socio-demographic characteristics of severe acquired brain injuries (ABI) in pediatric age are meager. In particular, in Italy we only find data concerning traumatic brain injury (TBI) in adults. Earlier data show that the most prevalent etiology in ABI is traumatic and that greater clinical impairments are reported for patients with non-traumatic etiologies.
  
  
  OBJECTIVE
  The main aims of the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione) study are: 1) to define the clinical features of pediatric patients with severe neurological disabilities; 2) to determine the etiology and onset modality of the cerebral lesions; and 3) to analyse the characteristics of the rehabilitation processes and patient outcome in terms of disability, strategies for treatment and clinical picture.
  
  
  METHODS
  Quasi-epidemiologic.
  
  
  METHODS
  In-patient.
  
  
  METHODS
  184 pediatric patients with severe ABI were recruited.
  
  
  METHODS
  Data collection was done by means of an assessment protocol created and used by a group of Italian neurorehabilitation centers. Traumatic and non traumatic aetiologies (NTBI) have been treated separately.
  
  
  RESULTS
  Traumatic etiology of ABI is the most prevalent (51.6%, N. 95) and about twice as many males as females are involved. Of these cases, 70.5% (N. 67) are the result of a car accident, either as a pedestrian or as a passenger, representing a crucial area for preventive action by the public health services. Eighty-six (46.7%) patients were in the acute state, 19 (10.3%) in subacute state and 76 (42.9%) in chronic condition. The results show that the positive trend for the TBI group was steeper than for NTBIs. Neuropsychological data are also discussed. CONCLUSIONS AND CLINICAL REHABILITATION IMPACT: We report the first Italian descriptive study on pediatric patients affected by ABI of traumatic or non traumatic etiology. The main points concerning rehabilitation are that major differences between aetiologies must be taken into account and that ABI of any severity in the acute phase may lead to long term disability, confirming the high social and economic impact of this pathology. Our study demonstrates the great importance of providing specialised rehabilitation centers for pediatric patients, and increases awareness of the importance of ABI prevention.
authors.affiliation: Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy. simone.gazzellini@opbg.net
authors.forename: S
authors.initials: S
authors.lastname: Gazzellini
authors.forename: S
authors.initials: S
authors.lastname: Strazzer
authors.forename: M
authors.initials: M
authors.lastname: Stortini
authors.forename: C
authors.initials: C
authors.lastname: Veredice
authors.forename: E
authors.initials: E
authors.lastname: Beretta
authors.forename: M L
authors.initials: ML
authors.lastname: Lispi
authors.forename: M E
authors.initials: ME
authors.lastname: Petacchi
authors.forename: M
authors.initials: M
authors.lastname: Menna
authors.forename: P
authors.initials: P
authors.lastname: Cipriani
authors.forename: M
authors.initials: M
authors.lastname: Zampolini
authors.forename: E
authors.initials: E
authors.lastname: Castelli
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D007902:Length of Stay / Q000639:trends; D008297:Male; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012047:Rehabilitation Centers; D015599:Trauma Severity Indices