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Awarded New Investigator/Doctoral Dissertation Grant

Pediatric Mild Head Injury: Definition and Consequences

FOA Number: CE04-046 - Grants for New Investigator Training Awards
Project Period: 8/01/04–07/31/05
Application/Grant Number: 1-R49-CE000284-01
Principal Investigator: Joshua B. Kay, PhD
The Regents of the University of Michigan
1500 E. Medical Center Drive
Ann Abor, MI 48109
Phone: 734-647-5195
Fax: 734-615-0995
E-mail: jbkay@umich.edu

Abstract

More than 1 million children in the United States sustain traumatic brain injury each year. Approximately 90% of pediatric brain injuries are described as mild, yet mild traumatic brain injury (MTBI) research is plagued by problems of classification, measurement, and generalization. This prospective, longitudinal study seeks to define pediatric MTBI according to empirically supportable criteria, to measure cognitive and psychological consequences on multiple occasions, and to account for the contribution of pre-morbid characteristics to the symptoms children experience post-injury.

Researchers will recruit 50 children ages 10 to 17 with MTBI who are treated in the emergency department (ED) but not hospitalized. MTBI will be defined by blunt trauma or acceleration-deceleration injury to the head followed by any combination of brief loss of consciousness (<30 minutes), brief post-traumatic amnesia (<24 hours), alteration in mental state at the time of the accident, and neurological deficits that may be transient. Glasgow Coma Scale scores will be 13 to 15 with no intracranial pathology on any neuroimaging studies. Fifty control children with comparably severe injuries not involving the head will be recruited in the ED. Relevant historical and demographic information will be obtained. Pre-injury psychological, behavioral, and executive functioning will be assessed via parent checklists. Neurocognitive functioning will be measured with instruments known to be sensitive to brain injury. Post-concussion symptoms (PCS) will be assessed using a questionnaire. The assessments will occur in the ED, 1 week later, and 1 month thereafter. The MTBI group is expected to demonstrate more PCS and neurocognitive deficits than controls immediately post-injury and at the 1 week follow up point. Considering prior findings, it is not clear whether the MTBI group will have more PCS and neurocognitive deficits 4 to 5 weeks post-injury. This study will contribute to the consistent definition of MTBI in children and set the stage for further investigations of the long-term consequences of head injury in children.

 
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