Pediatric TBI

Abstract

Pediatric traumatic brain injury (TBI) is the most common cause of acquired brain injury in childhood and leads to neuropathological, neurocognitive, and neurobehavioral morbidities. Unfortunately, these morbidities frequently persist and impact day-to-day long-term outcomes including adaptive behavior, educational attainment, employment, and quality of life. Relative risk of poor outcome is influenced by a variety of individual (e.g., age at injury, cognitive reserve), socioeconomic, and injury-related (e.g., duration of posttraumatic amnesia) factors. Certain sequelae, particularly neurocognitive deficits, have been tied to neuroanatomical abnormalities, most often via volumetric and diffusion tensor magnetic resonance imaging. While application of cognitive rehabilitation approaches has lagged behind that found in adult TBI, recent research has targeted neurocognitive function after pediatric TBI, with modest success albeit limited evidence of far transfer of effects. Neuroimaging has been very seldom used to assess treatment-related changes in brain system integrity after pediatric TBI but provides a robust opportunity to elucidate the mechanisms underlying response to intervention in this population.