Long term outcome from early childhood brain injury: 10 year follow up

该项目的主要目的是进一步提高我们对儿童创伤性脑损伤（TBI）长期后果的理解。在过去的十年中，我们的研究团队已经确定了一个持续TBI的儿童样本，并在5年内系统地跟踪了他们的进展。该项目享有国际声誉，在随访时间、前瞻性设计和代表性、维护良好的样本方面是独一无二的。我们的研究结果挑战了传统观点，即儿童具有弹性，可以从早期脑损伤中完全恢复。相反，我们已经表明，在TBI后长达5年，许多儿童在身体，认知和行为功能方面都会出现障碍。这些缺陷导致教育、职业、社会和情感问题，限制了儿童满足发展期望和实现适足生活质量的能力。这意味着这些问题将导致终身残疾，给个人、家庭和社区造成沉重负担。然而，由于随访数据仅限于5年，与成人模型中引用的2年期相比，持续的发育过程仍有可能支持儿童TBI的延长恢复期。在受伤后10年，对这一样本的审查提供了一个前所未有的机会，以解决这种可能性，并记录儿童进入青春期和成年期的恢复结果。并不是所有的孩子都有受伤后的问题。然而，预测个体结局仍然是一个重大挑战，与治疗和随访特别临床相关。因此，拟议研究的第二个目的是审查有助于恢复和结果的因素。

The primary aim of this project is to further improve our understanding of the long-term consequences of childhood traumatic brain injury (TBI). Over the past decade our research team has ascertained a sample of children sustaining TBI, and systematically followed their progress over a 5-year period. The project has an international reputation, and is unique in terms of length of follow-up, prospective design and representative, well-maintained sample. Our findings challenge the traditionally held view that children are resilient and recover fully from early brain insult. Rather, we have shown that, up to 5 years post-TBI, many children experience impairments in physical, cognitive and behavioural function. These impairments result in educational, vocational, social and emotional problems, limiting the child's capacity to meet developmental expectations and achieve adequate quality of life. The implication is that these problems will lead to life-long disability, resulting in high levels of individual, family and community burden. However, with follow-up data limited to 5 years, there remains a possibility that ongoing developmental processes may support an extended recovery period in childhood TBI, in comparison to the 2-year period cited in adult models. The review of this sample, 10 years post-injury, provides an unprecedented opportunity to address this possibility and to document recovery-outcome as children move into adolescence and adulthood. Not all children experience problems post-injury. However, predicting individual outcome remains a significant challenge, with particular clinical relevance to treatment and follow-up. Thus, the second aim of the proposed study is to examine factors that contribute to recovery and outcome.