Head Injury in Children Has Lasting Impact

Children with even mild head injury may be at risk for long-term complications, including personality changes and behavioral and learning problems, according to a new study from the UK.

"Many children with mild injury do not receive routine follow-up after discharge home from hospital, yet a significant proportion of them do have some lasting problems which may affect their behavior and ability to learn," Dr. Carol A. Hawley of the University of Warwick in Coventry stated.

"This may put them at a disadvantage at school," Hawley said.

To identify children suffering from the lingering effects of a head injury, Hawley's team is working on a questionnaire that physicians could send to parents after children with head injury are sent home from the hospital.

Children found to be at risk of problems could be offered a follow-up assessment, Hawley said. If necessary, children could be referred to an appropriate health professional, such as an educational psychologist, the UK researcher said.

Hawley's study included more than 500 children who had experienced a head injury over a 6-year period.

"We asked parents to tell us what changes they noticed in their child after the head injury, and what follow-up they had received from clinicians," Hawley explained.

The researchers also received questionnaires from a control group of parents of 45 children who had not had a head injury.

"Even after a mild head injury, one in five children had a change in personality according to their parents," Hawley said.

Parents often described the personality change as "like having a different child" than before the head injury, according to Hawley.

And 43 percent of children with mild head injury had behavioral or learning problems that led to them being described as having a "moderate disability," she said.

Among children with more serious head injuries, about two thirds had moderate disability, and about half experienced a major change in personality after the head injury, Hawley said.

All of the children in the study had been treated in a hospital after having a head injury, but only 30 percent of parents said that doctors at the hospital had made a follow-up appointment for their child. In fact, 161 of the 252 children with moderate disability did not receive any follow-up care, according to the report in the May issue of the Journal of Neurology, Neurosurgery, and Psychiatry.

"It is likely that there are considerable numbers of children in the community, and back at school, who have suffered a head injury in the past and who might have subtle but important difficulties relating to that head injury," Hawley said.

SOURCE: Journal of Neurology, Neurosurgery, and Psychiatry, May 2004.

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