The course of attention-deficit hyperactivity (ADH) symptomatology in 50 children and adolescents after traumatic brain injury (TBI) at 6 to 14 years of age was studied prospectively at the University of Iowa, Iowa City, IA. Changes in the ADH symptomatology and early onset of hyperactivity in the first 2 years after TBI were significantly related to the severity of the injury and degree of brain damage, and to a measure of family dysfunction, but a correlation with MRI findings was not documented. 
COMMENT. This study confirms previous reports of the relation between head injury and brain damage and the ADHD syndrome. It also demonstrates a positive “dose-response“ relationship between severity of injury and change in ADH symptoms. It is unfortunate that the MRI findings in this series of patients could not document a neuroanatomical correlate of the post-TBI change in ADH symptoms. The literature regarding head injury and ADHD is reviewed in .