ABBREVIATIONS
BRIEFBehavior Rating Inventory of Executive Function ImPACT Immediate post-concussion assessment and cognitive testing mCHI Mild closed head injury mTBI Mild traumatic brain injury Peabody Picture Vocabulary Test, 4th edition AIM The aim of this study was to determine whether volitional saccadic impairments are present in children with mild closed head injury (mCHI) and whether these deficits are predictive of ongoing cognitive impairment.METHOD We analysed a sample of 26 children with mCHI (20 males, 6 females; mean age 13y 1mo, SD 2y) and 29 age-matched comparison children (20 males, 9 females; mean age 12y 2mo, SD 2y). Participants completed a battery of saccadic eye movement tasks and a set of computer-based cognitive tasks at three time points: within 2 weeks of mCHI, and at 3 months and 6 months.
RESULTSThe group with mCHI made fewer errors on the antisaccade task at the first time point and showed increased latencies on prosaccades, correct antisaccades, and corrected antisaccade errors at the third time point (6mo). The group with mCHI also showed poorer performance on the cognitive tasks assessing memory.INTERPRETATION Even very mild, uncomplicated mCHI in children may persistently affect aspects of executive control and visual processing.Mild closed head injury (mCHI), or mild traumatic brain injury (mTBI), occurs when a blow to the head or a forceful motion of the head leads to brief loss of consciousness (<30min) or an alteration in mental state (e.g. confusion or disorientation), or any loss of memory for events before or after the incident. 1 The use of mCHI instead of mTBI does not explicitly imply the presence of brain injury. Although information on mTBI in children is limited, a recently completed prospective population-based study of 0-to 17-year-olds in Sweden yielded an annual incidence of 468 per 100 000.2 Evidence suggests that the prognosis after mTBI is good for most children; however, recent studies have observed that a significant proportion of these children experience ongoing problems. Hawley et al. 3 reported frequent behavioural, emotional, memory, and attention problems in 10% to 18% of children with mTBI, and personality change in 21%. Adults with mTBI often demonstrate difficulties with attention and working memory, and speed of processing (see Frencham et al. 4 for a meta-analysis). Research investigating the cognitive problems experienced by children with mTBI, however, is limited, with highly variable findings between studies. Anderson et al. 5 reported intact memory capacity over the course of both short-and long-term recovery after paediatric mTBI. Ponsford et al. 6 reported no impairment on a range of measures, including memory, attention, and processing speed at 1 week and 3 months after injury. However, Levin et al. 7 identified that children with 'complicated' mTBI, whose computed tomography (CT) revealed brain pathophysiology complications, had significantly poorer episodic memory and slower cognitive processing at short-and long-term follow-u...