title: Evaluation of a follow-up program for mild traumatic brain injury in schoolchildren.
abstract: BACKGROUND
  Mild traumatic brain injury is a common condition in childhood. Although classified as mild, post-concussive symptoms may persist and interfere with daily activities. Because no established guidelines exist with respect to follow-up medical care for these children, there may be a delay in receiving appropriate care. We developed a follow up program to screen for persistent symptoms and if necessary, refer patients for further medical assistance.
  
  
  METHODS
  From July 2010 until December 2013, eligible children aged 4-18 years who presented after sustaining a mild traumatic brain injury were included. All patients received a phone call after 6 weeks. After a period of 3 months, both their schoolteacher and parents were asked to complete in a questionnaire. The results were discussed monthly by a multidisciplinary team.
  
  
  RESULTS
  A total of 305 children were enrolled in our follow-up program. Headache was the most common acute symptom upon presentation (63%). Overall, 19% of all patients had problems, either at 6 weeks or 3 months. 14% of these patients were referred for special care. Most common persistent post-concussive symptoms were headache (32%), cognitive problems (23%) and behavioural problems (16%). After a period of two years, a review of patient charts revealed that all of the problems were resolved.
  
  
  CONCLUSIONS
  One fifth of the children exhibit post-concussive symptoms after mild traumatic brain injury. Education of patients and caregivers and a follow up visit if needed applied appropriate care at an early stage to minimise physical and mental problems.
authors.affiliation: Maastricht University Medical Centre+, PO-box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: relana.nowacki@mumc.nl.
authors.forename: R
authors.initials: R
authors.lastname: Nowacki
authors.affiliation: Maastricht University Medical Centre+, PO-box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: nicole.van.eldik@mumc.nl.
authors.forename: N
authors.initials: N
authors.lastname: van Eldik
authors.affiliation: Zuyderland Medical Centre, PO-box 4446, 6401 CX Heerlen, The Netherlands. Electronic address: m.eikens@zuyderland.nl.
authors.forename: M
authors.initials: M
authors.lastname: Eikens
authors.affiliation: Zuyderland Medical Centre, PO-box 4446, 6401 CX Heerlen, The Netherlands. Electronic address: r.roijen@zuyderland.nl.
authors.forename: R
authors.initials: R
authors.lastname: Roijen
authors.affiliation: Libra Rehabilitation & Audiology Centre, PO-box 5022, 5004 EA Tilburg, The Netherlands. Electronic address: n.haga@libranet.nl.
authors.forename: N
authors.initials: N
authors.lastname: Haga
authors.affiliation: Zuyderland Medical Centre, PO-box 4446, 6401 CX Heerlen, The Netherlands. Electronic address: n.schott@zuyderland.nl.
authors.forename: D
authors.initials: D
authors.lastname: Schott
authors.affiliation: Zuyderland Medical Centre, PO-box 4446, 6401 CX Heerlen, The Netherlands. Electronic address: t.sporken@zuyderland.nl.
authors.forename: T
authors.initials: T
authors.lastname: Simons-Sporken
authors.affiliation: Zuyderland Medical Centre, PO-box 4446, 6401 CX Heerlen, The Netherlands. Electronic address: ri.wennekes@zuyderland.nl.
authors.forename: M
authors.initials: M
authors.lastname: Wennekes
mesh_terms: D000293:Adolescent; D001924:Brain Concussion / Q000150:complications* / Q000523:psychology* / Q000534:rehabilitation; D002648:Child; D002675:Child, Preschool; D060825:Cognitive Dysfunction / Q000150:complications / Q000517:prevention & control / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006261:Headache / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D000066553:Problem Behavior / Q000523:psychology; D013997:Time Factors
keywords: Cognition; Follow-up; Mild traumatic brain injury (MTBI); Paediatrics; Post-concussive symptoms