Introduction

Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in youth worldwide. Though much remains to be learned, research focused on pediatric TBI has flourished in the last two decades. The current chapter will emphasize recent scientific literature relevant to understanding the consequences of moderate to severe TBI and the role of neuropsychological assessment in particular in characterizing and managing these difficulties. Epidemiological, pathophysiological, and intervention data will be highlighted as well. Outcomes and clinical care after uncomplicated mild TBI in children can be expected to differ from more severe injury; comprehensive reviews of this literature are available elsewhere [1, 2].

Epidemiology

In the USA, more than one million children and adolescents sustain TBI each year. Among children aged 0 to 14 years, TBI accounts for approximately 2700 annual deaths, 37,000 hospitalizations, and 435,000 emergency department visits [3]. Not surprisingly given such frequency, the associated financial costs are considerable. Annual hospitalization charges alone exceed $1 billion [4]. Rates and costs of all childhood TBI are undoubtedly much larger, as many milder injuries go unreported entirely or are treated in outpatient settings and remain unaccounted for in hospital-based estimates.

The incidence of TBI varies by severity, with mild TBI comprising 80 to 90% of all treated cases. Throughout childhood, boys are at considerably greater risk for TBI than girls.