COGNITIVE IMPAIRMENTS IN CHILDREN FOLLOWING TRAUMATIC BRAIN INJURY: CLINICAL SPECTRUM, NEUROPSYCHOLOGICAL ASSESSMENT, AND REHABILITATION OUTCOMES

Traumatic brain injury (TBI) is one of the leading causes of acquired cognitive disability in the pediatric population worldwide. Children who sustain mild, moderate, or severe TBI frequently demonstrate lasting deficits in attention, memory, executive function, processing speed, and academic achievement. The heterogeneity of injury severity and developmental stage at the time of injury complicates both diagnosis and treatment planning. This review aims to systematically characterize the spectrum of cognitive impairments observed after pediatric TBI, discuss validated neuropsychological assessment instruments, and summarize evidence-based rehabilitation strategies reported in recent literature. A narrative review was conducted of peer-reviewed publications indexed in PubMed, Scopus, and Google Scholar from 2005 to 2024. Studies involving children aged 0–17 years with diagnosed TBI and cognitive outcome data were included. Case reports and studies without control groups were excluded. Attention and working memory deficits are the most consistently reported sequelae across all TBI severity levels. Executive dysfunction, particularly in planning, cognitive flexibility, and inhibitory control, is prevalent in moderate-to-severe TBI. Age at injury is a critical moderator: injuries sustained before age five carry higher risk of pervasive cognitive delay due to disruption of ongoing brain maturation. Neuropsychological batteries such as NEPSY-II and the Cogstate Brief Battery demonstrate strong sensitivity for pediatric post-TBI assessment. Cognitive rehabilitation incorporating goal management training and computerized attention training shows moderate-to-large effect sizes.创伤性脑损伤（Traumatic brain injury, TBI）是全球儿科人群中获得性认知障碍的主要诱因之一。罹患轻度、中度或重度TBI的儿童，常持续表现出注意力、记忆、执行功能、处理速度及学业成就方面的持久缺损。损伤严重程度与受伤时发育阶段的异质性，使得诊断与治疗规划均面临复杂性。本综述旨在系统性刻画儿童TBI后出现的认知损伤谱系，讨论经过验证的神经心理学评估工具，并总结近年文献中报道的循证康复策略。 本研究对2005年至2024年间PubMed、Scopus及Google Scholar收录的同行评议文献开展叙述性综述。纳入研究需满足：研究对象为0至17岁经确诊的TBI患儿，且具备认知结局数据。排除个案报告及无对照组的研究。 注意力与工作记忆缺损是所有严重程度TBI中最常被报道的后遗症。执行功能障碍，尤其在规划、认知灵活性与抑制控制方面，在中重度TBI群体中较为普遍。受伤年龄是关键调节变量：5岁前遭受的颅脑损伤会因干扰正在进行的脑成熟进程，带来更高的广泛性认知延迟风险。诸如NEPSY-II与Cogstate Brief Battery的神经心理评估成套工具，对儿童TBI后评估具有较强敏感性。融合目标管理训练与计算机化注意力训练的认知康复方案，展现出中等到较大的效应量。