POST CONCUSSIVE SYMPTOMS: CHILDREN WITH MILD HEAD INJURY

儿童和家长经常报告各种症状 轻度闭合性头部损伤（CHI）。这些脑震荡后的症状 发生在没有任何客观证据的脑外伤，尽管 在标准认知测试中恢复得很好因此，辩论 继续关于脑震荡后的决定因素和后果， 轻度CHI后的症状。拟议研究的具体目的是 检查（1）自然历史，（2）预测，（3）后果 脑震荡后症状的儿童轻度CHI。该研究将涉及200 8 - 15岁轻度CHI儿童和100名轻度骨科损伤儿童 在同期队列/前瞻性研究设计中不涉及头部。的 第一年将对儿童及其家庭进行四次评估 损伤后（即，在损伤后1周、1个月、3个月和12个月）。 脑震荡后的症状将使用评定量表和访谈进行评估， 孩子和父母都是线人脑震荡后的预测因素 症状包括损伤特征、认知能力和 非伤害相关的儿童和家庭变量。评估的结果包括 学校表现、健康利用以及儿童和家庭的其他方面 功能本研究将探讨三个主要假设：（1）儿童与 轻度CHI的儿童比轻度CHI的儿童表现出更多的脑震荡后症状。 骨科损伤，尽管发生率的组间差异预计 随着症状类型和受伤后时间的变化而变化;（2） 脑震荡后的症状将与（a）损伤特征，（B） 损伤导致认知能力受损的程度，以及 (c)与儿童和家庭因素无关。这些关系又是 预计会因症状类型和受伤后的时间而变化;以及（3） 严重的脑震荡后症状将与更多的儿童残疾。 这项研究将使人们更清楚地了解伤害的作用， 特征、损伤后认知状态和非损伤相关因素 在轻度脑震荡后症状的发作和持续中起作用 儿童和青少年的CHI。这项研究还将提供深入了解 这些症状对儿童的功能影响。这些发现将有助于 解决关于轻度脑梗死相关结局的科学争议 CHI，并将协助医生和其他医疗保健提供者识别 轻度CHI的后遗症，并有效地管理它们。

Children and parents frequently report a variety of symptoms following mild closed-head injuries (CHI). These post-concussive symptoms often occur in the absence of any objective evidence of brain trauma and despite substantial recovery on standardized cognitive testing. Debate therefore continues regarding the determinants and consequences of post-concussive symptoms following mild CHI. The specific aims of the proposed study are to examine the (1) natural history, (2) prediction, and (3) consequences of post-concussive symptoms in children with mild CHI. The study will involve 200 8 to 15 year old children with mild CHI and 100 with mild orthopedic injuries not involving the head in a concurrent cohort/prospective research design. The children and their families will be assessed four times during the first year post-injury (i.e., at 1 week, 1 month, 3 months, and 12 months post-injury). Post-concussive symptoms will be assessed using rating scales and interviews, with both children and parents as informants. Predictors of post-concussive symptoms will include injury characteristics, cognitive abilities, and non-injury related child and family variables. Outcomes to be assessed include school performance, health utilization, and other aspects of child and family functioning. The study will examine three major hypotheses: (1) Children with mild CHI will display more post-concussive symptoms than children with mild orthopedic injuries, although group differences in incidence are expected to vary as a function of symptom type and time since injury; (2) The incidence of post-concussive symptoms will be related to (a) injury characteristics, (b) the extent to which the injury results in impairment in cognitive performance, and (c) non-injury related child and family factors. These relationships again are expected to vary as a function of symptom type and time since injury; and (3) Severe post-concussive symptoms will be associated with more child disability. The study will result in a clearer understanding of the roles that injury characteristics, post-injury cognitive status, and non-injury related factors play in the onset and persistence of post-concussive symptoms following mild CHI in children and adolescents. The study also will provide insights into the functional consequences of those symptoms for children. The findings will help resolve the scientific controversy regarding the outcomes associated with mild CHI, and will assist physicians and other health care providers in identifying the sequelae of mild CHI and managing them effectively.