mTBI is the commonest TBI in children. Persistent deficits after “mild” TBI can lead to significant functional disability; hence these should be evaluated.

This prospective analysis included 74 children with mTBI(M:F=52:22; mean age:9.5(±2.7)years). Wechsler’s Intelligence Scale for children-Indian adaptation(WISC-IV), Child Behavioral Checklist(CBCL) and Children’s Sleep Habit Questionnaire(CSHQ) were administered for 57 cases (at 3 months post injury) and controls of similar age.

DTI (1.5 T scanner; Siemens, Erlangen, Germany), done within 7days of injury, were processed for mean diffusivity(MD) and fractional anisotropy(FA) for various Region of Interest (ROI) which were correlated with IQ and various indices.

All the patients had non-penetrating craniocerebral trauma. Common causes of mTBI were accidental falls(65%) and Road traffic accident(26%). Presenting features were loss of consciousness(53%), confusion/disorientation(47%) and post-traumatic amnesia(10%). Other clinical features in acute phase included drowsiness(86%), headache(78%), balance problems(62%), nausea(47%), fatigue(45%), vomiting(35%), ENT bleed(12%), Sensitivity to sound/ light(12%) etc. Neuroimaging abnormalities were seen in 9 patients (12%).

At 3months post-injury, Cases performed poorly in terms of Full scale IQ, Perceptual Reasoning Index and Processing Speed Index as compared to typically developing controls of similar age.

Based on CBCL, 17% children with mild TBI had internalizing behavioural problems (in borderline and clinical range) in comparison to 4% controls. Prevalence of poor sleepers in mild TBI cohort and typically developing controls was 12.3% and 2%. Headache, reduced attention span, shortness of temper and fatigue were common post concussion symptoms.

There was a positive co relation between Right Arcuate fasciculus MD (short term) and VCI (0.289) and PSI (0.299)

Mild TBI is not that mild with neurobehavioral problems persisting beyond the acute phase of injury.