The sequelae of mild head injury one to five years after injury, assessed in a longitudinal study of 13,000 British children born in one week in 1970, are reported from the Albert Einstein College of Medicine, Bronx, NY and Bristol Polytechnic and University of Bristol, England. Parental reports of mild head injury in 114 children treated with ambulatory care or admission to hospital for one night were compared with those of 601 children with limb fractures, 605 with lacerations, 136 with burns, and 1726 without injury. When the children were five and ten years of age the parents completed the Rutter Child Behavior Questionnaire. At age ten teachers also answered questions from both the Rutter and Conners’ questionnaires. The picture vocabulary test was used to assess overall intelligence at age five and subtests of the British Abilities Scale were used at age ten. Children with head injuries were statistically indistinguishable from uninjured children on all tests except the teachers’ report of hyperactivity which was 4/10 of a standard deviation higher. The authors concluded that mild head injury in school aged children does not have an adverse effect on global measures of cognition, achievement, and behavior one to five years after injury. 
COMMENT. Head injuries reported as concussion and which result in ambulatory care or hospitalization of one night do not have an effect on general intelligence, achievement, and aggression measured one to five years after the injury. The increase in hyperactive behavior was considered of doubtful significance. The teachers reports of hyperactivity were not likely to be biased but hyperactivity unrecognized by the parents before the injury may have resulted in greater vulnerability to head injury. Evaluated as a group, the occurrence of hyperactivity may not be remarkable but in those children who lost consciousness and required admission to hospital, the sequel of hyperactivity might be significant and worthy of careful follow-up and management.