Abstract for presentation at 6th World Congress on Brain Injury

Introduction: Traumatic extradural haematoma (EDH) in children is regarded as having a good outcome, but to date there has been little research into the affects of EDH.
Aim: To define cognitive and psychological outcome in children with surgically treated EDH one month after injury compared to matched uninjured controls.
Methods: Prospective study. TBI severity was classed by admission Glasgow Coma Score (GCS) as mild, moderate, or severe (GCS 13-15; GCS 9-12; GCS 3-8). Cognitive outcome was assessed by the WISC-III (short form) Test of Everyday Attention in Children (TEA-ch) and the Children’s Memory Scales (CMS). Psychological outcome was assessed by the Birleson Depression Scale (BDS), Impact of Events Scale(IES) and Child Behaviour Checklist(CBCL).
Results: 12 children with EDH and 12 matched controls were recruited over the 2 years. 8/12 were boys. Mean age was 12 yrs, range 6-16. 9/12 were injured in a RTA, 3/12 in a fall. 4 children had GCS <8, 4 had GCS 9-12 and 4 had GCS 13-15. All the EDH children underwent surgical evacuation; all had good neurological outcome. At follow up, EDH children scored significantly lower than controls on Performance IQ (p=0.016) and TEA-ch Map Mission(p=0.01). There was no significant difference between EDH children and controls for Verbal IQ (p=0.50), TEA-ch Dual Task (p=0.11) and Opposite Worlds (p=0.21) or CMS; however, 3/12 were unable to complete the CMS. There was no significant difference between EDH children and controls for BDS (p=0.16) but a highly significant difference between EDH children and controls for CBCL Total Problem Score (p<0.001), Externalising Score (p=0.003) and Internalising Score (p=0.009). 3/11 children who completed the IES scored >17, indicating possible Acute Stress Disorder; 1/12 was too psychologically disturbed to complete the IES.
Conclusion: The results suggest EDH children are at risk of cognitive and psychological problems and that follow up is therefore indicated.