| 1. |
- Aaro Jonsson, Catherine, 1963-, et al.
(författare)
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Long-term cognitive outcome after neurosurgically treated childhood traumatic brain injury
- 2009
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Ingår i: Brain Injury. - : Taylor & Francis. - 0269-9052 .- 1362-301X. ; 23:13-14, s. 1008-1016
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore the cognitive long term outcome of two cohorts of patients neurosurgically treated for childhood traumatic brain injury (CTBI), either in 1987-1991 according to an older concept, or 1997-2001 with a stronger emphasis on volume targeted interventions. Research design and methods: Participants in the two cohorts were subject to an extensive neuropsychological assessment, 13.2 and 6.1 years post injury, respectively. In a between group design, assessment results of the two cohorts, n 18 and n 23, were compared to each other and to controls. Data were analyzed with multivariate analyses of variance. Results: Long-term cognitive deficits for both groups of similar magnitude and character were observed in both groups. Abilities were especially low regarding executive and memory function and verbal IQ. The cognitive results are discussed in terms of vulnerability of verbal functions and decreased executive control over memory-functions. Conclusions: There is a definite need for long term follow up of cognitive deficits after neurosurgically treated CTBI, also with the newer neurosurgical concept. Verbal learning and the executive control over memory functions should be addressed with interventions aimed at restoration, coping and compensation.
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| 2. |
- Aaro Jonsson, Catherine, 1963-, et al.
(författare)
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Neuropsychological progress during 14 years after severe traumatic brain injury in childhood and adolescence
- 2004
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Ingår i: Brain Inj. - : Informa UK Limited. - 0269-9052 .- 1362-301X. ; 18:9, s. 921-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate the impact of time since injury on neuropsychological and psychosocial outcome after serious TBI in childhood or adolescence. METHODS: The subjects were eight patients with serious TBI sustained at a mean age of 14 years who had been assessed neuropsychologically at 1, 7 and 14 years after TBI. A retrospective longitudinal design was chosen to describe the development in six neuropsychological domains on the basis of the assessments. Psychosocial data were gathered from clinical knowledge and a semi-structured interview 14 years after TBI. RESULTS: Performance of verbal IQ shows a declining trend over the three assessments, that the performance of attention and working memory is low and that verbal learning is the cognitive domain which exhibits the largest impairments. The main psychosocial result is that three of the eight subjects went from a school situation with no adjustments to adult life with early retirement. CONCLUSIONS: Time since insult is an important factor when assessing outcome after TBI in childhood and adolescence and that assessment of final outcome should not be done before adulthood.
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| 3. |
- Emanuelson, Ingrid, et al.
(författare)
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Traumatic brain injury in children treated at the neurosurgical unit at Sahlgrenska University Hospital in 1987-1991 and 1997-2001: An analysis of the process of care
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: In 1992, a new volume targeted treatment, the “Lund Protocol”, was introduced in the field of neurosurgical care at Sahlgrenska University Hospital. The mortality rate for adults dropped markedly while the number of patients in a vegetative state remained at the same level. As yet, changes in mortality and outcome for children have not been investigated in detail. Aim: To describe the causes and severity of injury, process of care from emergency care to rehabilitation, and the rate of received rehabilitation and to follow-up two cohorts treated for child traumatic brain injury (CTBI) before and after the initiation of the “Lund Protocol”. For group 2, treated after the initiation of the “Lund Protocol” an additional aim was to relate brain injury severity parameters in the acute care stage to functional outcome. Methods: A retrospective population-based study of patient records of former paediatric patients treated neurosurgically for CTBI between 1987-1991 and 1997-2001. Epidemiological results are presented as descriptive statistics. To evaluate the relationship between brain injury parameters and outcome an exploratory cluster analysis was performed on the data from group 2. Results: For both groups traffic accidents were the most common cause of injury. The Glasgow Coma Scale indicated a more severe injury level in group1. The mortality rate in group1 was 8 % compared with 2 % in group 2 (n.s.). The Glasgow outcome score was on the same level (median 5), and the rate of received rehabilitation was equally low in both groups, 27 % versus 33 %. The cluster analysis revealed that length of care and time in a respirator had a stronger relationship with outcome than the Reaction Level Scale (RLS). Conclusion: There is still no stable process of care after CTBI as 67 % in the later treated group did not receive rehabilitation and 50 % of those did not receive any medical check- ups in the long- term perspective.
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