Hemophilia and Concussion Outcome Study (HeCos): Neurological Status of Children with Hemophilia—Prevalence and Relevance of Mild Traumatic Brain Injury

Background: Mild traumatic brain injury (mTBI) is a common pediatric incident. Despite this, only sparse data exist on the prevalence and consequences of mTBI in patients with hemophilia (PWHs). mTBI itself may impact a child's development, as has been reported for children without hemophilia. Since traumatic injuries, including mTBI, are often well documented for PWHs as incidents leading to factor substitution are generally documented in the patients’ substitution diaries, PWHs could form an interesting and well-documented patient group to study mTBI and its possible consequences.

Aims: This study aims at documenting the prevalence of mTBI in PWHs and at reporting on the neurological status of PWH.

Methods: Cross-sectional study, including 50 PWHs aged 4 to 17 years. Investigation of motor proficiency (Hemophilia Joint Health Score, BOT -2 Bruininks-Oseretsky Test, HEP-Test-Q), neurological status (mild neurological dysfunction, posturography, gait analysis, dual-task gait paradigm), and psychological aspects (Haemo-QoL Questionnaire, Child Behavior Checklist). Patient records and substitution diaries are reviewed to document the following: head injury and its consequences (i.e. factor substitution, medical presentation, inpatient monitoring, imaging), documented further bleeds, including joint bleeds, and medical history including treatment and complications. The study was approved by the local institutional review board and informed consent was obtained from all participants and their caregivers.

Results: The study is still ongoing. Until abstract submission retrospective chart analysis was performed for all eligible patients and n = 20 patients have been clinically evaluated. Until presentation at the congress n = 40 participants are anticipated to be included. Their data will be presented.

Conclusion: Based on the findings, the significance of regular neuropediatric/developmental status assessments within care programs for patients suffering hemophilia may be discussed. The clinical outcome after head injury in PWHs may be closely followed to provide rehabilitation or specialized therapy (i.e. occupational therapy) at an early stage.

 

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Publikationsverlauf

Artikel online veröffentlicht:
26. Oktober 2022