Skip to main content Accessibility help
Hostname: page-component-8bbf57454-q5g9d Total loading time: 0.77 Render date: 2022-01-25T22:13:46.489Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

69 - Prognosis and recovery of pediatric head injury

from Part VIII - Trauma

Published online by Cambridge University Press:  08 January 2010

P. David Adelson
Department of Pediatric Neurosurgery, Children's Hospital of Pittsburgh and the University of Pittsburgh, Pittsburgh, Pennsylvania, USA
Neil Buxton
Department of Paediatric Neurosurgery, Royal Liverpool Children's Hospital, Liverpool, UK
Richard Appleton
The Roald Dahl EEG Unit, Department of Paediatric Neurology, Royal Liverpool Children's Hospital, Liverpool, UK
Mark D. Stringer
University of Otago, New Zealand
Keith T. Oldham
Children's Hospital of Wisconsin
Pierre D. E. Mouriquand
Debrousse Hospital, Lyon
Get access



Trauma remains a significant societal and public health problem in the world, especially in children. It is the leading cause of death and disability accounting for over 50% of the deaths in the pediatric population. Head trauma occurs in the majority of these cases and is a major factor affecting both mortality and outcome. There are frequent long-term cognitive, motor and behavioral dysfunctions in severely injured children, even in those children who have suffered mild or moderate head injuries. However, determining the prognosis and outcome following head injury in children has been difficult. Recently, much has been learned about how children respond acutely to traumatic brain injury but relatively little is known about the differences in long-term outcome and prognosis in the different age ranges and among individuals.

In reviewing the prognosis and recovery potential of children following brain injury, several aspects of childhood impact on the developing brain that are unique and which must be taken into consideration. It is critical to try and understand the effect that a brain injury has during the different stages of brain development. In addition, the degree of neuroplasticity from birth and early brain growth to the final mature adult brain will also alter the final prognosis. Lastly, the impact of an intervention may differ at different stages of maturation.

Pediatric Surgery and Urology
Long-Term Outcomes
, pp. 926 - 935
Publisher: Cambridge University Press
Print publication year: 2006

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


Guyer, B. & Ellers, B.Childhood injuries in the United States. Mortality, morbidity, and cost. Am. J. Dis. Child. 1990; 144:649–652.CrossRefGoogle ScholarPubMed
Wegman, W. E.Annual summary of vital statistics – 1981. Pediatrics 1982; 75:835–843.Google Scholar
Gross, C. R., Wolf, C., Kunitz, S. al. Pilot Traumatic Coma Data Bank: a profile of head injuries in children. In Dacey, R. G. al. (eds.): Trauma of the Central Nervous System. New York: Raven Press, 1985:19–26.Google Scholar
Walker, M. L., Mayer, T. A., Storrs, B. al.Pediatric head injury – factors which influence outcome. Concepts Pediatr. Neurosurg. 1985; 6:84–97.Google Scholar
Oddy, M., Coughlan, T., Tyerman, al.Social adjustment after closed head injury. A further follw-up seven years after injury. J. Neurol., Neurosurg., Psychiatry 1985; 48:564–568.CrossRefGoogle Scholar
Mahoney, W. J., Souza, B. J., Haller, al.Long-term outcome of children with severe head trauma and prolonged coma. Pediatrics 1983; 71(5):756–762.Google ScholarPubMed
Luerssen, T. G., Klauber, M. R., & Marshall, L. F.Outcome from head injury related to patient's age. A longitudinal prospective study of adult and pediatric head injury. J. Neurosurg. 1988; 68:409–416.CrossRefGoogle ScholarPubMed
Kraus, J. F., Fife, D., & Conroy, C.Pediatric brain injuries: the nature, clinical course, and early outcomes in a defined United States' population. Pediatrics 1987; 79(4):501–507.Google Scholar
Annegers, F. The epidemiology of head trauma in children. In Shapiro, I. (ed.) Pediatric Head Trauma. New York: Futura Publishing Co., 1983.Google Scholar
Boyer, M. G. & Edwards, P.Outcome 1 to 3 years after severe traumatic brain injury in children and adolescents. Injury 1991; 22(4):315–320.CrossRefGoogle ScholarPubMed
Demellweek, C., Baldwin, T., Appleton, R., & Al-Kharusi, A.A prospective study and review of pre-morbid characteristics in children with traumatic brain injury. Pediatr. Rehab. 2002; 5:81–89.CrossRefGoogle ScholarPubMed
Bruce, D. A., Raphaely, R. C., Goldberg, A. al.Pathophysiology, treatment and outcome following severe head injury in children. Child's Brain 1979; 5:174–191.Google ScholarPubMed
Choi, S. C., Barnes, T. Y., Bullock, al.Temporal profile of outcomes in severe head injury. J. Neurosurg. 1994; 81:169–173.CrossRefGoogle ScholarPubMed
Christoffel, K. K.Violent death and injury in US children and adolescents. Am. J. Dis. Child. 1990; 144:697–706.Google ScholarPubMed
Duhaime, A. C., Alario, A. J., Lewander, W. al.Head injury in very young children: Mechanism, injury types, and ophthalmologic findings in 100 patients younger than 2 years of age. Pediatrics 1992; 90:179–185.Google ScholarPubMed
Hendrick, E. B., Harwood-Harsh, D. C. F., & Hudson, A. R.Head injuries in children: a survey of 4,465 consecutive cases at the Hospital for Sick Children, Toronto, Canada. Clin. Neurosurg. 1964; 11:46–64.CrossRefGoogle Scholar
Mohanty, A., Kolluri, V. R. S., Subbakrishna, D. al.Prognosis of extradural haematomas in children. Pediatr. Neurosurg. 1995; 23:57–63.CrossRefGoogle ScholarPubMed
Bruce, D. A., Schut, L., Bruno, L. al.Outcome following severe head injuries in children. J. Neurosurg. 1978; 48:679–688.CrossRefGoogle ScholarPubMed
Aldrich, E. F., Eisenberg, H. M., Saydjari, al.Diffuse brain swelling in severely head-injured children A report from the NIH Traumatic Coma Data Bank. J. Neurosurg. 1992; 76:450–454.CrossRefGoogle ScholarPubMed
Graham, D. I., Ford, I., & Adams, J. H.Fatal head injury in children. J. Clin. Pathol. 1989; 42:18–22.CrossRefGoogle ScholarPubMed
Berger, M. S., Pitts, L. H., Lovely, al. Outcome from severe head injury in children and adolescents. J. Neurosurg. 1985; 62:194–199.CrossRefGoogle ScholarPubMed
Johnston, R. B. & Mellits, E. D.Pediatric coma: prognosis and outcome. Develop. Med. Child. Neurol. 1980; 22:3–12.CrossRefGoogle ScholarPubMed
Jennett, B., Teasdale, G., Braakman, al.Prognosis of patients with severe head injury. Neurosurgery 1979; 4(4):283–289.CrossRefGoogle ScholarPubMed
Bagnato, S. J. & Mayes, S. D.Patterns of developmental and behavioral progress for young brain-injured children during interdisciplinary intervention. Develop. Neuropsychol 1986; 2(3):213–240.CrossRefGoogle Scholar
Bruce, D. A., Alavi, A., Bilaniuk, L. al.Diffuse cerebral swelling following head injuries in children: the syndrome of “malignant brain edema”. J. Neurosurg. 1981; 54:170–178.CrossRefGoogle ScholarPubMed
Moura dos, Santos A. L., Plese, J. P. P., Ciquini, O. al.Extradural haematomas in children. Paediatr. Neurosurg. 1994; 21:50–54.CrossRefGoogle Scholar
Alberico, A. M., Ward, J. D., Choi, S. al.Outcome after severe head injury. Relationship to mass lesions, diffuse injury, and ICP course in pediatric and adult patients. J. Neurosurg. 1987; 67:648–656.CrossRefGoogle ScholarPubMed
Becker, D. P., Miller, J. D., Word, J. al.The outcome from severe head injury with early diagnosis and intensive management. J. Neurosurg. 1982; 56:26–32.Google Scholar
Klonoff, H., Low, M. D., & Clark, C.Head injuries in children: a prospective five year follow-up. J. Neurol. Neurosurg. Psychiatry 1977; 40:1211–1219.CrossRefGoogle ScholarPubMed
Kumar, R., West, C. G. H., Quirke, al.Do children with severe head injury benefit from intensive care?Child's Nerv. Syst. 1991; 7:299–304.CrossRefGoogle ScholarPubMed
Young, B., Rapp, R. P., Norton, J. al.Early prediction of outcome in head-injured patients. J. Neurosurg. 1981; 54:300–303.CrossRefGoogle ScholarPubMed
Levin, H. S., High, W. M. Jr., Ewing-Cobbs, al.Memory functioning during the first year after closed head injury in children and adolescents. Neurosurgery 1988; 22:1043–1052.CrossRefGoogle ScholarPubMed
Pagni, C. A., Signoroni, G., Crotti, al.Severe traumatic coma in infancy and childhood: results after surgery and resuscitation. J. Neurosurg. Sci. 1975; 19:120–128.Google Scholar
Levin, H. S., Aldrich, E. F., Saydjari, al.Severe head injury in children: experience of the Traumatic Coma Data Bank. Neurosurgery 1992; 31(3):435–444.CrossRefGoogle ScholarPubMed
Brink, J. D., Garrett, A. L., Hale, W. al.Recovery of motor and intellectual function in children sustaining severe head injuries. Develop. Med. Child. Neurol. 1970; 12:565–571.CrossRefGoogle ScholarPubMed
Levin, H. S., Eisenberg, H. M., Wigg, N. al.Memory and intellectual ability after head injury in children and adolescents. Neurosurgery 1982; 11:668–673.CrossRefGoogle ScholarPubMed
Koskiniemi, M., Kyykka, T., Nybo, al.Long-term outcome after severe brain injury in preschoolers is worse than expected. Arch. Pediatr. Adolesc. Med. 1995; 149:249–254.CrossRefGoogle ScholarPubMed
Raimondi, A. J. & Hirschauer, J.Head injury in the infant and toddler. Child's Brain 1984; 11:12–35.Google ScholarPubMed
Ewing-Cobbs, L., Miner, M. E., Fletcher, J. al.Intellectual, motor, and language sequelae following closed head injury in infants and preschoolers. J. Pediatr. Psychol. 1989; 14(4):531–547.CrossRefGoogle ScholarPubMed
Brooks, N., McKinlay, W., Symington, al.Return to work within the first seven years of severe head injury. Brain Injury 1987; 1:5–19.CrossRefGoogle ScholarPubMed
Heiskanen, O. & Kaste, M.Late prognosis of severe brain injury in children. Develop. Med. Child. Neurol. 1974; 16:11–14.CrossRefGoogle ScholarPubMed
Jaffe, K. M., Fay, G. C., Polissar, N. al.Severity of pediatric traumatic brain injury and early neurobehavioral outcome: a cohort study. Arch. Phys. Med. Rehabil. 1992; 73:540–547.Google ScholarPubMed
Knights, R. M., Ivan, L. P., Ventureyra, E. C. G., et al.The effects of head injury in children on neuropsychological and behavioral functioning. Brain Injury 1991; 5(4):339–351.CrossRefGoogle Scholar
Laurent-Vannier, A., Brugel, D. G., & Agostini, M.Rehabilitation of brain injured children. Childs Nerv. Syst. 2000; 16(10–11):760–764.CrossRefGoogle ScholarPubMed
Levin, H. S., Culhane, K. A., Fletcher, J. al.Dissociation between delayed alternation and memory after pediatric head injury: relationship to MRI findings. J. Child. Neurol. 1994; 9:81–89.CrossRefGoogle ScholarPubMed
Chadwick, O., Rutter, M., & Brown, G.A prospective study of children. IV. Specific cognitive deficits. J. Clin. Neuropsych. 1981; 3:101–120.CrossRefGoogle ScholarPubMed
Stuss, D. T., Ely, P., Hugenholtz, al.Subtle neuropsychological deficits in patients with good recovery after closed head injury. Neurosurgery 1985; 17:41–47.CrossRefGoogle ScholarPubMed
Winogron, H. W., Knights, R. M., & Bawden, H. N.. Neuropsychological deficits following head injury in children. J. Clin. Neuropsych. 1984; 6:269–286.CrossRefGoogle ScholarPubMed
Bawden, H. N., Knights, R. M., & Winogron, H. W.Speeded performance following head injury in children. J. Clin. Exp. Neuropsychol. 1985; 7(1):39–54.CrossRefGoogle ScholarPubMed
Jaffe, K. M., Polissar, N. L., Fay, G. C., & Liao, S.Recovery trends over three years following pediatric traumatic brain injury. Arch. phys. Med. Rehabil. 1995; 76(1):17–26.CrossRefGoogle ScholarPubMed
Beaulieu, C. L.Rehabilitation and outcome following pediatric traumatic brain injury. Surg. Clin. North. Am. 2002; 82(2):393–408.CrossRefGoogle ScholarPubMed
Jennett, B.Trauma as a cause of epilepsy in childhood. Dev. Med. Child. Neurol. 1973; 15:56–62.CrossRefGoogle ScholarPubMed
Appleton, R. E. & Demellweek, C.Post-traumatic epilepsy in children requiring inpatient rehabilitation following head injury. J. Neurol. Neurosurg. Psychiatry 2002; 72:669–672.CrossRefGoogle ScholarPubMed
Hahn, Y. S., Fuchs, S., Flannery, A. al.Factors influencing post-traumatic seizures in children. Neurosurgery 1988; 22:864–867.CrossRefGoogle Scholar
Lewis, R., Yee, L., Inkelis, al.Clinical predictors of post-traumatic seizures in children with head trauma. Ann. Emerg. Med. 1993; 22:1114–1118.CrossRefGoogle ScholarPubMed
Rutter, M., Chadwick, O., & Shaffer, D. Head injury. In Rutter, M. (ed). Developmental Neuropsychiatry. New York: Guilford Press, 1983; 83–111.Google Scholar
Dillon, H. & Leopold, R. L.Children and post-concussion syndromeJ. Am. Med. Assoc. 1961; 175:86–92.CrossRefGoogle ScholarPubMed
Emanuelson, I., Wendt, L., Lundalv, al.Rehabilitation and follow up of children with severe traumatic brain injury. Childs Nerv Syst. 1996; 12:460–465.CrossRefGoogle ScholarPubMed
Levin, H. S.Neurobehavioral recovery. J. Neurotrauma 1992; 9:S359–373.Google ScholarPubMed
Bagnato, S. J. & Neisworth, J. T.Neurodevelopmental outcomes of early brain injury: a follow-up of fourteen case studies. TECSE 1989; 9(1):72–89.Google Scholar

Send book to Kindle

To send this book to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats