Neurobehavioral outcome after closed head injury in childhood and adolescence
C. M. Filley, L. D. Cranberg, M. P. Alexander and E. J. Hart
Hospital records of 53 children and adolescents, aged 18 years or less,
with closed head injury were reviewed for information on long-term outcome.
Computed tomographic scans were used to divide the patients into
clinicopathologic groups. Within these groups, duration of coma was the
major index of severity. Outcome was assessed using the Glasgow Outcome
Scale and by evaluating social behavior, school performance, and vocational
functioning. Patients with diffuse injury plus focal lesions fared worse
than those with diffuse injury only. Coma lasting more than one month led
to a poorer outcome in both groups. Many individuals had limiting emotional
disturbances, which may have resulted from disruption of frontal systems
modulating arousal and social behavior.