Challenges and effectiveness of remote neurological follow-up of children with concussion following TBI using telemedicine

Abstract

Background: Traumatic brain injury (TBI) in children, including concussion, is one of the major causes of emergency department (ED) registration and a significant burden on the health system. Objectives: The primary goal of this study was to evaluate the outcomes of a telemedicine strategy for remotely monitoring the children with traumatic brain concussions, focusing on their neurological symptoms and signs. The secondary goal was to explore socioeconomic and educational differences among the participating families. Methods: This study was conducted in a prospective and observational fashion. It included children aged between 6 and 18 years who presented in the ED with head trauma and were subsequently diagnosed with a brain concussion. Enrolled patients split into telemedicine-only and telemedicine + readmission groups according to their concussion symptoms during video-call visits. Results: We recruited 29 children and performed 75 telehealth visits. Four children were called for readmission, and they comprised the telemedicine + readmission group. The telemedicine-only group included 25 children whose follow-ups were completed remotely. The median PECARN score was 1 (IQR = 0.75), and the most common reason for head trauma was simple falls from the same level (n = 18, 62%); 22 (76%) children were suffering from headaches; 55% of the families were in very low-income status. During the video-call visit sessions, three children stated worse headaches, and one child’s parents reported consistent sleepiness. Conclusion: This study demonstrates the potential effectiveness of telemedicine in monitoring children with concussions, especially in regions with diverse socioeconomic backgrounds and overcrowded metropolitan hospitals.