Predicting postconcussive symptoms after mild traumatic brain injury in children and adolescents: 2020 update

Abstract

The vast majority of traumatic brain injuries (TBI) in children are of mild severity. A small but significant proportion of children with mild TBI experience persistent postconcussive symptoms (PCS), with negative consequences for their longer-term psychosocial functioning and quality of life. A key issue for clinical management is how to predict which children with mild TBI will go on to display persistent PCS. This chapter provides an overview of the existing literature regarding the prediction of PCS following mild TBI in children and adolescents, considering both injury-related and non-injury-related factors as possible prognostic indicators. The chapter summarizes conceptual and methodological issues that arise in research on the prediction of the outcomes of mild TBI and describes recent advances in the development of evidence-based decision rules that help to predict which children are at high risk for poor outcomes after mild TBI. The chapter concludes with suggestions for future research, the long-term goal of which is to enable clinicians to determine which children are at risk for poor outcomes after mild TBI.