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Persistent post-concussive syndrome in children after mild traumatic brain injury is prevalent and vastly underdiagnosed
Abstract
Data on epidemiology and prognosticators of persistent post-concussion syndrome (PPCS) after mild traumatic brain injury (mTBI) in the pediatric population is scarce. The aim of this study was to evaluate the prevalence of PPCS in children after mTBI and to identify clinical variables in children who are at high risk for developing PPCS. A multicenter, retrospective matched cohort in which PPCS symptoms were evaluated in children 8–15-year-old, 6–60 months after being admitted to the emergency department because of mTBI. The control group included children admitted to the emergency department because of uncomplicated distal radius fractures. The children's guardians were interviewed for the presence of PPCS symptoms using the "Rivermead Post-Concussion Questionnaire". A multivariable logistic regression model was used to identify predictors of PPCS. Two-hundred and five children were included in the mTBI group and 205 in the control. The median time from the injury was 33.5 months in the mTBI group and 33.8 in the control. The prevalence of PPCS in the mTBI group was 25.3% and PPCS like symptoms in the control was 2.4%, p < 0.001. Within the 6–60 months period, the PPCS prevalence was not influenced by the time that elapsed from the injury. In the mTBI group, motor vehicle accidents and adolescence were found to be risk factors for PPCS. PPCS is underdiagnosed in the pediatric population and 25% of children admitted to the ED due to mTBI may suffer from PPCS. Screening guidelines should be implemented to identify and properly treat these children.
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“approximately 25% of pediatric patients experience persistent post-concussive symptoms after the acute injury (Fried et al., 2022).”
From A systematic review of brain structural and functional alterations in pediatric mild traumatic brain injury (2026) · cites this paper as Fried et al., 2022
In the citing paper
“Despite increasing awareness, PCS in children continues to be overlooked by clinicians and educators. Many children experiencing long-term post-injury symptoms do not receive a formal diagnosis or appropriate interventions, allowing their difficulties to persist untreated into adulthood (7).”
From Hyperbaric oxygen therapy improves post-concussion symptoms in adults with childhood traumatic brain injury: a retrospective cohort study (2025) · cites this paper as [7]
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Cited by
Lambert, M., Sheldrake, E., Deneault, A.-A., Wheeler, A., Burke, M., & Scratch, S. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.48453 · Cited by 51
Shabi Shlifer, A., Suzin, G., Shorer, R., Lang, E., Finci, S., Elman-Shina, K., Doenyas-Barak, K., & Efrati, S. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1641033 · Cited by 2
Self-citationXu, H., Wu, S., Zhan, H., Xu, G., Zhao, J., & Yin, B. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1879109
Metadata
- Authors
- Fried, E., Balla, U., Catalogna, M., Kozer, E., Oren-Amit, A., Hadanny, A., & Efrati, S.
- Venue
- Scientific Reports
- Published
- 2022-03-14
- Volume
- 12
- Issue
- 1
- ISSN
- 2045-2322
- Cited by
- 57
- References
- 4
- Language
- en
- Licence
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
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