Exploring the causes and impact of pediatric complicated mild traumatic brain injuries.

PM & R : the journal of injury, function, and rehabilitation 2026-09-09

Andrew D. Kramer, Arianna B. Lanpher, Matthew Mervis, Madison Koval, Zachary Jager, Masaru Teramoto, Michael M. Green

Abstract

Background Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children, with mild TBI (mTBI) accounting for approximately 80% of cases. Complicated mTBI (c-mTBI) is characterized by radiographic evidence of intracranial abnormalities and/or skull fractures. Understanding the etiology and epidemiological trends of c-mTBI in the pediatric population is crucial for prevention and management strategies. Objective To fill gaps in current knowledge of pediatric c-mTBI, potentially leading to improved clinical outcomes and targeted interventions. Methods This is a single-site, retrospective cohort study at a Level 1 Pediatric Trauma Center, reviewing the cases of pediatric patients diagnosed with a c-mTBI from 2017 to 2023. Data were extracted from the institution's trauma registry, including demographic information, injury mechanism, imaging findings, length of hospital and intensive care unit stays, and surgical intervention frequencies. Descriptive statistics were used to assess the distribution of injuries by age, gender, mechanism, and temporal factors. Results Of those meeting inclusion criteria, 761 (59.6%) were male. The mean age was 6.2 years (SD = 5.7). The highest incidence of injury was in those Conclusion Pediatric c-mTBI predominantly affects males and younger children, with falls as the leading cause across all age groups. As children age, sports-related injuries become more prevalent, with motor vehicle accidents contributing in adolescence. Seasonal and temporal patterns suggest targeted prevention strategies may reduce injury burden.