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  • Question 3 Should stimulants be administered to manage diffi culties with attention, hyperactivity and impulsivity following paediatric acquired brain injury?

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Question 3 Should stimulants be administered to manage diffi culties with attention, hyperactivity and impulsivity following paediatric acquired brain injury?
  1. David W Harvey1,
  2. Matthew Morrall2,
  3. Elizabeth Neilly3,
  4. Deborah Murdoch-Eaton4
  1. 1Programme in Clinical Psychology, University of Leeds, Leeds, UK
  2. 2Department of Paediatric Neuropsychology, The Leeds Teaching Hospitals NHS Trust, Leeds, UK
  3. 3Health Sciences Library, University of Leeds, Leeds, UK
  4. 4Department of Paediatric Neurology, The Leeds Teaching Hospitals NHS Trust and University of Leeds, Leeds, UK
  1. Correspondence to Matthew C H J Morrall, Department of Paediatric Neuropsychology, Paediatric Psychology Services, The Leeds Teaching Hospitals NHS Trust, E Floor, Martin Wing, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK; matthew.morrall{at}leedsth.nhs.uk

https://doi.org/10.1136/archdischild-2012-302250

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    Scenario

    An 11-year-old boy is struck by a car and sustains an acquired brain injury (ABI). He is admitted with a Glasgow Coma Scale score of 6/15. Cranial imaging reveals evidence of diffuse injury. Approximately 12 months later following discharge, the patient is seen for a planned review. The patient and his family report poor attention with hyperactive and impulsive behaviours. The school has reported to parents that there has been a change in his ability to concentrate at school and he is being disruptive in class. This represents a clear departure from the patient's preinjury behaviour. Parental and school management of this concerning conduct is structured and consistent. You have heard that stimulant medication may be of benefit in managing difficulties with attention, hyperactivity and impulsivity (attention deficit hyperactivity disorder (ADHD) type behaviours) following an ABI.

    Structured clinical question

    For children with an acquired brain injury [patient], does the administration of stimulant medication [intervention] help address inattention, impulsivity and hyperactivity [outcomes]?

    Search strategy and outcome

    Secondary sources

    The Cochrane Library (including Cochrane Reviews, Database of Abstracts of Review of Effects and Clinical Trials) was searched.

    Primary sources

    Using a combination of subject headings and keyword terms, an advanced search was conducted of AMED (1985–present), BIOSIS Previews (1969–present), CAB Abstracts (1910–present), EMBASE (1947–present), Medline (1950–present), PsycINFO (1806–present), CINAHL (1981–present), Google Scholar, Global Health (1973–present) and Conference Papers Index for conference proceedings (1982–present).

    Search terms

    Search terms (designed for Medline and tailored accordingly for other sources) were: (exp Brain Injuries/OR Brain Neoplasms/ OR brain adj2 injur* …

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