title: Mild head injury and attention deficit hyperactivity disorder in children.
abstract: OBJECTIVE
  Post-concussion syndrome is a well-described complication following moderate and severe head trauma but whether it occurs after mild head injury in children remains unclear. The aim of this study was to evaluate whether exposure to mild head injury with potential additional risk factors (non-surgical lesion on computed tomographic, high kinetic trauma, or Glasgow Coma Scale <15) is associated with attention deficit hyperactivity disorder (ADHD) after the head trauma.
  
  
  METHODS
  This study was performed in an emergency department on children admitted between 2009 and 2013. It compared victims of mild head injury aged 6-16 years with matched children presenting isolated non-surgical forearm fracture (ratio1/2). ADHD was assessed using Conners' Global Index-Parent short version 3-40 months after the trauma. The patients were compared using chi-square test or Fisher's exact test, t test or u-test as appropriate with a p value set at 0.05.
  
  
  RESULTS
  During the study period, 676 patients were admitted for mild head injury. Among them, 34 (5 %) fulfilled the inclusion criteria and were compared with 64 matched patients admitted for a forearm fracture. The groups were comparable. ADHD was observed in both groups (18 % in the mild head injury group, 11 % in the control group) with no significant differences between groups. The prevalence was high when compared to an expected frequency of 3.5-5.6 % in children aged 6-12 years in the general population.
  
  
  CONCLUSIONS
  These results suggest that pre-existing ADHD may have contributed to injury proneness in both groups and does not argue for a specific risk of ADHD induced by mild head injury. The diagnosis of ADHD should be evoked at admission of children aged 6-16 years presenting with a trauma.
authors: Department of Pediatrics and Emergency Medicine, Rennes University Hospital, Rennes, France.
authors: Veronique
authors: V
authors: Chasle
authors: Department of Pediatric Neurosurgery, Rennes University Hospital, Rennes, France. laurent.riffaud@chu-rennes.fr.|INSERM, UMR 1099 LTSI, University of Rennes 1, Rennes, France. laurent.riffaud@chu-rennes.fr.
authors: Laurent
authors: L
authors: Riffaud
authors: Department of Pediatrics and Emergency Medicine, Rennes University Hospital, Rennes, France.
authors: Romain
authors: R
authors: Longuet
authors: Department of Physical Medicine and Rehabilitation, Rennes University Hospital, Rennes, France.
authors: Marie
authors: M
authors: Martineau-Curt
authors: Department of Pediatrics and Emergency Medicine, Rennes University Hospital, Rennes, France.
authors: Yann
authors: Y
authors: Collet
authors: Department of Pediatric Neurosurgery, Rennes University Hospital, Rennes, France.
authors: Luc
authors: L
authors: Le Fournier
authors: Department of Pediatrics and Emergency Medicine, Rennes University Hospital, Rennes, France.|INSERM, UMR 1099 LTSI, University of Rennes 1, Rennes, France.
authors: Patrick
authors: P
authors: Pladys
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000209:etiology*; D001924:Brain Concussion / Q000523:psychology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence
keywords: Attention deficit hyperactivity disorder; Cognitive impairment; Controlled study; Mild head injury