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Journal of Head Trauma Rehabilitation:
doi: 10.1097/HTR.0b013e3181f8d32e
Original Articles

Do Postconcussive Symptoms Discriminate Injury Severity in Pediatric Mild Traumatic Brain Injury?

Moran, Lisa M. MA; Taylor, H. Gerry PhD; Rusin, Jerome MD; Bangert, Barbara MD; Dietrich, Ann MD; Nuss, Kathryn E. MD; Wright, Martha MD; Yeates, Keith Owen PhD

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Abstract

Objectives: To assess whether postconcussive symptoms (PCS) can be used to discriminate injury severity among children with mild traumatic brain injury (TBI).

Participants: One hundred eighty-six children with mild TBI, divided into high and low injury severity depending on whether the injury was associated with a loss of consciousness (LOC), and a comparison group of 99 children with orthopedic injuries (OI), all aged 8 to 15 years at the time of injury.

Main Measures: Parent-rated frequency and severity of PCS at initial assessment within 2 weeks postinjury and again at 3 and 12 months postinjury.

Results: Ratings of PCS obtained at the initial and 3-month assessments differentiated children with mild TBI from OI, although only ratings at the initial assessment discriminated among all 3 groups. Somatic PCS accounted for most of the discriminatory power.

Conclusions: Overall, the accuracy of group classification was relatively modest, with a large proportion of misclassifications of children in the mild-TBI groups. Although children with mild TBI have more PCS than children with OI, PCS do not permit sufficiently accurate discrimination of mild TBI and injury severity to warrant diagnostic decisions at this time.

© 2011 Lippincott Williams & Wilkins, Inc.

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