Table 1.
Patient |
Sex |
Age |
GCS |
Severity |
Age at injury |
Time since injury |
Completed trial? |
Cause of TBI |
History of ADHD |
Medication |
PTA (or why not) |
---|---|---|---|---|---|---|---|---|---|---|---|
(years) | Y = yes | ||||||||||
1 |
M |
14 |
< 8 |
Severe |
5 years |
9 |
Y |
Paed versus MVAb |
Reported 'no’ |
DEX 5 mg bd |
Not done (age) |
2 |
F |
10 |
? |
Severe |
18 months |
8 |
Y |
NAIa |
Too young |
Unknown |
Not done (age) |
3 |
M |
13 |
3 |
Severe |
9 years |
4 |
Y |
MVA |
Concentration and learning difficulties; but no diagnosis |
DEX 10 mg mane and lunch |
Not available |
4 |
F |
11 |
6 |
Severe |
6 years |
5 |
Y |
Paed versus MVAb |
Unknown |
MPH 10 mg mane 5 mg lunch |
34 days |
5 |
M |
16 |
10 |
Severe |
12 years |
4 |
Y |
Fall (6 m) |
Concentration and learning difficulties; but no diagnosis |
MPH 30 mg mane |
4 weeks |
6 |
M |
16 |
15 |
Moderate to severe |
14 years |
2 |
N |
Bicycle (fall) |
Reported 'no’ |
MPH LA |
1 to 2 days |
7 |
M |
Approximately 13 |
< 8 |
Severe |
9 years |
Approx 5 |
N |
Bicycle versus MVA |
Pre-injury ADHD diagnosis and treatment (methylphenidate) |
MPH |
Not done (nonverbal) |
8 |
M |
15 |
? |
Moderate |
4 years |
11 |
N |
Paed versus MVAb |
Reported 'no’ |
MPH 10 mg am and lunch |
Not available (likely not done) |
Unconscious 10–15 minutes | |||||||||||
9 |
F |
13 |
5 |
Severe |
6 years |
7 |
N |
NAIa |
No developmental concerns prior to injury |
MPH 10 mg mane 15 mg lunch |
Not available (likely not done) |
Unconscious 10 to 15 minutes | |||||||||||
10 | F | 8 | 11 | Moderate | 26 months | 6 | N | NAIa | Too young | Concerta 36 mg | Not done (age) |
Comp, completed trial; DEX, dexamphetamine; GCS, Glasgow Coma Scale; MPH, methylphenidate; MVA, motor vehicle accident; aNon-accidental injury; bPedestrian hit by motor vehicle; PTA, post-traumatic amnesia. Note 3 and 5 had reported exacerbation of concentration and learning difficulties post TBI.
Imaging
1. Computer tomography (CT) head (time of injury): fracture of the left ethmoid region as well as parenchymal haemorrhages in the right occipital region.
2. CT head (time of injury): injuries included bilateral subdural haematomas and bilateral retinal haemorrhages. There were no fractures associated with the injury.
3. CT (initial; reported): he had a right extradural haematoma and significant cerebral contusions including his frontal lobe.
4. CT scan (initial) showed a diastasis of the right occipito-temporal suture in addition to a minimally displaced base of skull fracture, no intracranial lesions and a probable fracture through the left TMJ articular fossa.
5. Comminuted and depressed skull fracture of the right parietal and frontal bones (transversing the skull at the base of the sphenoid), with multiple areas of contusion and haemorrhage in the right frontal and temporal lobes with midline shift and overall swelling of the right cerebral hemisphere with midline shift.
6. Left temporal fracture with left extradural haematoma and haemorrhagic contusions involving the frontal and temporal lobes.
7. Diffuse axonal injury, multiple contusions, cerebral oedema, uncal and tonsillar herniation and haemorrhages involving the left basal ganglia and left cerebellum.
8. Not done.
9. Large left subdural haematoma with associated cerebral oedema.
10. Left frontal subdural of 7 mm with 5 mm midline shift.