Some Kids’ Head Injuries Heal Slower

ADHD may hinder mild traumatic brain injury recovery in youth

(RxWiki News) When your kid is out biking, playing baseball or doing some other physical activity, you may worry about their safety, especially if he or she has a mental health condition.

According to new research, mild traumatic brain injury was more likely to moderately disable children with attention deficit hyperactivity disorder (ADHD) than children without ADHD.

"Ensure the physical safety of active children."

Christopher Bonfield, MD, a neurosurgeon at the University of Pittsburgh Medical Center Presbyterian, was the study's main author.

Dr. Bonfield and his fellow researchers examined the medical charts of 48 youth from the Children's Hospital of Pittsburgh who already had been diagnosed with ADHD and then were diagnosed with mild traumatic brain injury.

These researchers compared that group of ADHD patients with head injuries to a group of 45 patients of similar ages who did not have ADHD but who had also been diagnosed with mild brain trauma. The youth ranged in age from 6 to 17 years. Of the group, 90 percent were boys.

At the end of about 25 weeks of follow-up monitoring and care, 25 percent of the head-injured children with ADHD had moderate disabilities. During the same 25 weeks, 56 percent of them were completely recovered.

Moderate disabilities, for example, included needing another person's assistance to go up and down stairs or get dressed. Falling more often and other physical problems related to the central nervous system also were signs of moderate disability.

By comparison, the recovery period for brain-injured children without ADHD lasted for about seven weeks. During that time, 2 percent of that second group had a moderate disability, and 84 percent completely recovered.

For both groups of kids overall, 17 percent of injuries resulted from falling. The remainder occurred during sporting events, all-terrain vehicle or bicycle accidents, blows to the head with a blunt object, getting hit by a car while walking and other events.

The researchers wrote that they were not surprised that children with a pre-existing mental condition such as ADHD would take longer to get well.

ADHD is a neurobehavioral problem marked by periods of being unusually inattentive and being extremely active. In 2003, the first year covered by the roughly seven year study, 7.8 percent of youth in the United States had ADHD, the researchers wrote. That amounted to about 4.4 million kids.

The researchers suggested that parents of children with ADHD consider steering them away from activities with higher risks of head injury. The researchers also concluded that doctors should provide specific counseling about recovery from mild traumatic brain injury for families of injured children with ADHD.

"This is especially pertinent, given [previous] data that children with ADHD are reported to sustain higher levels of injury [compared to youth without ADHD]," the researchers wrote. "This study may better inform the clinical management of children who have ADHD and experienced [closed-head injury], perhaps directing more intensive resources and closer monitoring to encourage maximal recovery."

The researchers said their findings suggest that additional studies are needed to determine the impact of ADHD on brain injuries and the relationship between the disorder and the injury.

Traumatic brain injury is a leading cause of death, disability and damage to normal development of children in the United States. Each year, 7,000 children die from such injuries, the researchers wrote. The injuries are also responsible for 60,000 hospitalizations and 600,000 emergency room visits each year.

This study was published June 25 in the Journal of Neurosurgery: Pediatrics.

The researchers reported that they had no financial investment or other involvement that would influence study design or outcomes.

Review Date: 
June 18, 2013