Neuropsychiatric sequelae in TBI: a comparison across different age groups

Objective: Traumatic brain injury (TBI) is the leading cause of death and permanent disability in developmental age. Neurobehavioural symptoms are not uncommon in these patients. The aim of this study was to identify the main neuropsychiatric sequelae of TBI at different ages and study the possible correlations with clinical features in the acute phase and outcome in order to better plan rehabilitative treatment and re-entry into society.

Method: Ninety-six post-traumatic patients, ranging from 0-18 years, underwent a complete psychological evaluation protocol at 1 year from trauma. Patients were divided into three different age groups (0-6 years; 7-13 years; 14-18 years) and received a protocol made up of age-appropriate scales.

Results: Different psychological problems were found across the three groups; more frequently younger patients show internalizing problems such as withdrawal and closure, while, with age, behaviour problems become more frequent, characterized by hyperactivity and aggressiveness. Factors that were most predictive of psychological, behaviour and adjustment problems include GOS scores, the degree of impairment on the neurological examination and male gender.

Conclusions: Psychological and behavioural problems differ across the three age groups and determine a different outcome, rehabilitation plan and re-entry into society. These problems should, thus, be investigated and treated specifically according to age.