{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T16:41:06Z","timestamp":1794328866479,"version":"4.9.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,8,1]]},"abstract":"\n BACKGROUND:<\/jats:title>\n Much disagreement exists as to whether postconcussion syndrome (PCS) is attributable to brain injury or to other factors such as trauma alone, preexisting psychosocial problems, or medicolegal issues. We investigated the epidemiology and natural history of PCS symptoms in a large cohort of children with a mild traumatic brain injury (mTBI) and compared them with children with an extracranial injury (ECI).<\/jats:p>\n <\/jats:sec>\n \n METHODS:<\/jats:title>\n This investigation was a prospective, consecutive controlled-cohort study of 670 children who presented to a tertiary referral emergency department with mTBI and 197 children who presented with ECI. For all participants, data were collected by use of a telephone interview of a parent 7 to 10 days after injury. If a change from preinjury symptoms was reported by a parent, follow-up continued monthly until symptom resolution. Outcomes were measured by using the Post Concussion Symptom Inventory, Rivermead Postconcussion Symptom Questionnaire, Brief Symptom Inventory, and Family Assessment Device.<\/jats:p>\n <\/jats:sec>\n \n RESULTS:<\/jats:title>\n There was a significant difference between the mTBI and ECI groups in their survival curves for time to symptom resolution (log rank [Mantel-Cox] 11.15, P &lt; .001). Three months after injury, 11% of the children in the mTBI group were symptomatic (13.7% of children older than 6 years) compared with 0.5% of the children in the ECI group. The prevalence of persistent symptoms at 1 year was 2.3% in the mTBI group and 0.01% in the ECI group. Family functioning and maternal adjustment did not differ between groups.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS:<\/jats:title>\n Among school-aged children with mTBI, 13.7% were symptomatic 3 months after injury. This finding could not be explained by trauma, family dysfunction, or maternal psychological adjustment. The results of this study provide clear support for the validity of the diagnosis of PCS in children.<\/jats:p>\n <\/jats:sec>","DOI":"10.1542\/peds.2009-0925","type":"journal-article","created":{"date-parts":[[2010,7,26]],"date-time":"2010-07-26T21:50:05Z","timestamp":1280181005000},"page":"e374-e381","source":"Crossref","is-referenced-by-count":574,"title":["Epidemiology of Postconcussion Syndrome in Pediatric Mild Traumatic Brain Injury"],"prefix":"10.1542","volume":"126","author":[{"given":"Karen Maria","family":"Barlow","sequence":"first","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Clinical Neurosciences,"},{"name":"Alberta Children's Hospital Research Institute for Children and Maternal Health, Calgary, Alberta, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Crawford","sequence":"additional","affiliation":[{"name":"Alberta Children's Hospital Research Institute for Children and Maternal Health, Calgary, Alberta, Canada; and"},{"name":"Behavioural Research Unit and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Stevenson","sequence":"additional","affiliation":[{"name":"Psychology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep Sona","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Clinical Neurosciences,"},{"name":"Psychology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Belanger","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Division of Pediatric Emergency, Department of Pediatrics, Alberta Children's Hospital, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Dewey","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"},{"name":"Alberta Children's Hospital Research Institute for Children and Maternal Health, Calgary, Alberta, Canada; and"},{"name":"Behavioural Research Unit and"},{"name":"Community Health Sciences, University of Calgary, Calgary, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,8,1]]},"reference":[{"issue":"9","key":"2021120820160219400_B1","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1177\/002221948702000903","article-title":"Epidemiology of pediatric closed head injury: incidence, clinical characteristics, and risk factors","volume":"20","author":"Goldstein","year":"1987","journal-title":"J Learn Disabil"},{"issue":"2","key":"2021120820160219400_B2","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1080\/026990500120827","article-title":"Emergency department visits associated with traumatic brain injury: United States, 1995\u20131996","volume":"14","author":"Guerrero","year":"2000","journal-title":"Brain Inj"},{"issue":"7250","key":"2021120820160219400_B3","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1136\/bmj.320.7250.1631","article-title":"Disability in young people and adults one year after head injury: prospective cohort study","volume":"320","author":"Thornhill","year":"2000","journal-title":"BMJ"},{"key":"2021120820160219400_B4","doi-asserted-by":"crossref","unstructured":"Langlois\u2008JA, Rutland-Brown\u2008W, Thomas\u2008KE. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2006. Available at: www.cdc.gov\/ncipc\/pub-res\/TBI_in_US_04\/TBI_ED.htm.\u2008Accessed June 15, 2010","DOI":"10.1037\/e721222007-001"},{"issue":"3","key":"2021120820160219400_B5","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1097\/01.yco.0000165601.29047.ae","article-title":"Outcome from mild traumatic brain injury","volume":"18","author":"Iverson","year":"2005","journal-title":"Curr Opin Psychiatry"},{"issue":"3","key":"2021120820160219400_B6","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1080\/026990596124494","article-title":"Minor head injury: attempts at clarifying the confusion","volume":"10","author":"Kibby","year":"1996","journal-title":"Brain Inj"},{"issue":"3","key":"2021120820160219400_B7","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1080\/026990599121683","article-title":"Recovery from mild head injury","volume":"13","author":"Bernstein","year":"1999","journal-title":"Brain 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