ADHD often manifests after milder pediatric traumatic brain injury in children, underscoring necessity for prolonged follow-up care. In a retrospective exploratory cohort from a pediatric concussion clinic, investigators assessed whether demographic factors or acute clinical features were associated with secondary ADHD (S-ADHD) after mild traumatic brain injury.
The study reviewed patients seen from 2010–2023. Of 284 screened pediatric traumatic brain injury cases, 198 were excluded due to missing initial or final SCAT scores, pre-existing ADHD, or incomplete assessments. The final analytic sample included 86 children, split into an S-ADHD group (n=10) and a non-ADHD group (n=76), based on a new diagnosis made by a pediatric neurologist.
No Clear Acute Predictors of Later ADHD
When comparing groups, the authors found no statistically significant differences in age or sex. They also reported no significant between-group differences in acute clinical symptoms that can accompany concussion and mild traumatic brain injury, including loss of consciousness, confusion, or amnesia.
This lack of distinguishing early features is clinically relevant because acute post-injury symptoms can overlap with attention and behavioral changes, potentially complicating early identification of ADHD following mild traumatic brain injury in children.
Follow-up Duration Stood Out
A key difference emerged in follow-up duration. Children later diagnosed with S-ADHD had significantly longer follow-up than those not diagnosed with ADHD, with a median of 536 versus 132 days (p < 0.001). The authors interpreted this finding as support for extended monitoring, since S-ADHD may become apparent later rather than in the immediate post-injury window.
The investigators emphasized the exploratory nature of the work and called for larger cohorts to identify reliable early indicators of ADHD following mild traumatic brain injury in children.
Reference: Astigarraga Baez JM et al. Attention-Deficit/Hyperactivity Disorder Following Mild Traumatic Brain Injury in Children: A Retrospective Exploratory Study. Cureus. 2025;17(11):e96831.
