Cognitive and psycho-emotional disorders in children after traumatic brain injuries: Causes, clinical picture and therapy

Traumatic brain injury (TBI) is a major public health concern with an estimated not less than 3 million children worldwide affected annually. It can result in death or disability, especially in patients with moderate or severe TBI. According to the Federal State Statistics Service (Rosstat), in Russia 1,014.3 thousand cases of head injury were registered in children aged 0 to 17 years (3,353.5 per 100,000 children) in 2023, which is second only to wrist/hand injuries and ankle/foot injuries in terms of figures. Children who had TBIs may suffer not only from movement disorders associated with brain injury, but also have a combination of cognitive, behavioural, and emotional impairments that may persist for a long period of time after the injury. Children with moderate to severe TBIs develop deficits that persist into adulthood, affecting education and employments outcomes, psychosocial functioning, and quality of life. Post-concussion syndrome, the most common complication of mild TBI, can develop in all age groups. Dysexecutive syndrome has been shown to be present during the acute period of recovery from TBI and may persist over the long-term horizon. Executive functions are crucial for a child's academic performance and overall development. Blood biomarkers have been explored for their potential to provide objective measures in the assessment of injury severity and to help identify children at risk for delayed recovery of CNS functions. Medical treatment for children with TBI should include a multidisciplinary approach and creation of individual trajectories of recovery programs with due account for identified disorders. Choline alfoscerate is a promising effective drug to correct neurodevelopmental disorders and recover cognitive functions in children after TBI.