| 1. |
- Sörbo, Ann, 1955, et al.
(författare)
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Outcome after severe brain damage, what makes the difference?
- 2005
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Ingår i: Brain Inj. ; 19:7, s. 493-503
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess and compare the consequences for outcome in terms of the dimensions of activity and participation for two groups: group A, which received early formalized rehabilitation, and group B, which received late or no formalized rehabilitation. RESEARCH DESIGN: A cross-sectional study. PROCEDURE: Twenty-six patients (A: n = 14 and B: n = 12) with severe brain damage were included. The participants were assessed a mean of 26.6 months (SD 7.1, median 25, range 14-41) after the incident using the structured form for the Swedish Neuro database, the Glasgow Outcome Scale (GOS), the Extended Glasgow Outcome Scale (GOSE) and the Functional Independence Measure (FIM). RESULTS: The study reveals a better outcome for group A. No patient remained in a vegetative state in group A as compared with three in group B. In group A, 50% were independent as compared with 17% in group B. The frequency of return to work was 43% in group A, but no patient in group B had returned to work.
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| 2. |
- Aaro Jonsson, Catherine C., et al.
(författare)
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Variability in quality of life 13 years after traumatic brain injury in childhood
- 2014
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Ingår i: International Journal of Rehabilitation Research. - : Wolters Kluwer. - 0342-5282 .- 1473-5660. ; 37:4, s. 317-322
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Tidskriftsartikel (refereegranskat)abstract
- With the aim of describing variability in the long-term outcome of quality of life after neurosurgically treated pediatric traumatic brain injury, mostly self-reports of 21 individuals with mild or moderate/severe injury were gathered using Mayo-Portland Adaptability Inventory in telephone interviews 13 years aftyer injury. A majority of the participants reported brain injury-related problems. The median outcome on Mayo-Portland Adaptability Inventory was mild to moderate limitations. The variation within the moderate/severe group varied between relatively good outcome and moderate/severe limitations. Concentration, irritability, fatigue, and transportation were reported as the most problematic areas, whereas self-care was reported as well functioning. Societal participation appeared to be the best functional domain in this Swedish study. Examples of individual reports of the life-situation at various outcome levels were provided. Variability in outcome is large within severity groups, and research may gain by addressing both outcomes of the individuals and groups. Objective questions of outcome should be accompanied by questions of actual functioning in everyday life. To ensure long-term support for quality of life for those with remaining dysfunction after pediatric traumatic brain injury, healthcare systems should implement systematic routines for referral to rehabilitation and support.
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| 3. |
- 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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| 4. |
- 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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| 5. |
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| 6. |
- Dahl, E., et al.
(författare)
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A prospective, population-based, follow-up study of mild traumatic brain injury in children
- 2006
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Ingår i: Injury. - : Elsevier BV. - 0020-1383. ; 37:5, s. 402-9
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Outline the annual incidence of mild traumatic brain injury in children, aged 0-17 years, using the American Congress of Rehabilitation Medicine classification and record the presence of new symptoms up to six months after injury. SETTINGS AND METHODS: The study population comprised all the children in the age group of 0-17 years (a total of 40,984) in an administrative district in south-western Sweden. All the individuals registered in the Brain Injury Register, during the periods 1 January to 30 June 1999 and 1 April to 30 September 2000, fulfilling the inclusion criteria defined by American Congress of Rehabilitation Medicine, were included. New symptoms occurring three to six months after the injury were recorded using a mailed 21-item questionnaire. RESULTS: 192 children fulfilled the criteria, yielding an annual incidence of 468/100,000 (95% CI 402-535/100,000). Boys accounted for 57 per cent and fall injuries accounted for 61 per cent of the external causes. New symptoms were reported by 24 per cent of those who answered the questionnaire. CONCLUSION: This study revealed that the annual incidence of mild traumatic brain injury in children was almost as high as that among adults in the same area and population.
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| 7. |
- Elgmark Andersson, Elisabeth, et al.
(författare)
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Mild traumatic brain injuries: the impact of early intervention on late sequelae. A randomized controlled trial
- 2007
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Ingår i: Acta Neurochir (Wien). - : Springer Science and Business Media LLC. - 0001-6268 .- 0942-0940. ; 149:2
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Positive results from early clinical intervention of mild traumatic brain injury (MTBI) patients by rehabilitation specialists have been reported. Various treatments have been used, but few controlled studies are published. We hypothesised that early rehabilitation of selected MTBI patients would reduce long term sequelae. METHOD: A randomised controlled trial with one year follow-up. Among 1719 consecutive patients with MTBI, 395 individuals, 16-60 years of age, met the MTBI definition. Exclusion criteria were: previous clinically significant brain disorders and/or a history of substance abuse. The control group (n = 131) received regular care. The intervention group (n = 264) was examined by a rehabilitation specialist. 78 patients were mainly referred to an occupational therapist. The problems were identified in daily activities and in terms of post-concussion symptoms (PCS), an individualised, tailored treatment was given. Primary endpoint was change in rate of PCS and in life satisfaction at one-year follow-up between the groups. FINDINGS: No statistical differences were found between the intervention and control groups. Patients who experienced few PCS two to eight weeks after the injury and declined rehabilitation recovered and returned to their pre-injury status. Patients who suffered several PCS and accepted rehabilitation did not recover after one year. INTERPRETATION: In this particular MTBI sample, early active rehabilitation did not change the outcome to a statistically-significant degree. Further studies should focus on patients with several complaints during the first 1-3 months and test various types of interventions.
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| 8. |
- Elgmark Andersson, Elisabeth, et al.
(författare)
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The new Swedish Post-Concussion Symptoms questionnaire: a measure of symptoms after mild traumatic brain injury and its concurrent validity and inter-rater reliability.
- 2006
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Ingår i: Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 38:1, s. 26-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the concurrent validity and the inter-rater reliability of the Post-Concussion Symptoms Questionnaire. DESIGN: The approach was to study the concurrent validity of the Post-Concussion Symptoms Questionnaire when used as an interview questionnaire compared with a self-report questionnaire administered by the patients. The inter-rater reliability was also studied when 2 different raters administered the Post-Concussion Symptoms Questionnaire interview. PATIENTS: Thirty-five patients with mild traumatic brain injury were consecutively contacted by telephone and asked whether they would be willing to participate in a follow-up intervention. METHODS: The Post-Concussion Symptoms Questionnaire was completed by the patients, who answered "Yes" or "No" to the standardized questions. The patients were then interviewed to check the certain "Yes" or "No" answers, 0-10 days after having completed the first Post-Concussion Symptoms Questionnaire. The raters filled in their ratings independently. RESULTS: The concurrent validity of answers in the questionnaire compared with those in the interview ranged from 82% to 100% agreement. The inter-rater reliability results ranged from 93% to 100% agreement between the raters. CONCLUSION: The Post-Concussion Symptoms Questionnaire with answers of "Yes" or "No" is a valid instrument. High reliability was found between the raters.
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| 9. |
- Emanuelson, Ingrid, 1955, et al.
(författare)
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Computed tomography and single-photon emission computed tomography as diagnostic tools in acquired brain injury among children and adolescents.
- 1997
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Ingår i: Developmental medicine and child neurology. - 0012-1622. ; 39:8, s. 502-7
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Tidskriftsartikel (refereegranskat)abstract
- Twenty children with acquired brain injuries were investigated with CT and SPECT. The findings were related to the clinical outcome judged at discharge following acute care after the injury and at follow-up 5 years later. The abnormalities that were found were classified for each lobe on a scale ranging from 0 (normal) to 5 (severe abnormality). The patients were divided into two groups showing mild and severe injury. CT and SPECT revealed similar results in the patients with severe injury, but in the group of mildly injured children the number of affected lobes and scores indicated by SPECT were significantly higher than those indicated by CT. SPECT also differentiated more effectively between the two outcome groups. This supports the hypothesis that SPECT could be used as an instrument to objectivise minor sequelae and that SPECT and CT are both useful methods for forecasting outcome.
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| 10. |
- Emanuelson, Ingrid, 1955, et al.
(författare)
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Occurrence of epilepsy during the first 10 years after traumatic brain injury acquired in childhood up to the age of 18 years in the south western Swedish population-based series.
- 2009
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Ingår i: Brain injury : [BI]. - : Informa UK Limited. - 1362-301X .- 0269-9052. ; 23:7, s. 612-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The risk of seizures is increased after a traumatic brain injury (TBI), but the impact and duration of this increased risk is not well characterized in children. OBJECTIVE: To identify post-traumatic epilepsy (PTE) and post-concussion symptoms 10 years after a TBI during childhood. RESEARCH DESIGN: The study is a population-based retrospective follow-up study. PROCEDURE: Ten years after brain injury all 165 survivors, who as children (<18 years) in 1987-1991 as residents in the south western Swedish health care region had had a TBI, were invited to participate in a follow-up. A questionnaire regarding medical conditions and medication was filled out by the patients themselves or their parents as was a 21-item questionnaire (PCSQ) regarding post-concussion symptoms. Of the surviving 165 individuals, 109 participated (67%). RESULTS: Eight of 109 developed immediate seizures. During the follow-up period 12/109 had developed active epilepsy. Of these 12, five had had immediate seizures. The incidence of developing PTE within 10 years after a TBI was thus in this series 11%. The relative risk to develop late onset post-traumatic epilepsy (> or =1 week after injury) for those who had had immediate seizures was 9.018 (p = 0.0003, 95% CI = 3.69-22.05). CONCLUSIONS: TBI is a relatively rare cause of epilepsy in childhood, although immediate seizures are associated with an increased risk of developing post-traumatic epilepsy.
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