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Long-term cognitive outcome after neurosurgically treated childhood traumatic brain injury
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Institution for clinical sciences, Dept. of pediatrics, Sahlgrenska Academy at Göteborg University.
Institution for clinical sciences, Dept. of pediatrics, Sahlgrenska Academy at Göteborg University.
2009 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 23, no 13-14, 1008-1016 p.Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis , 2009. Vol. 23, no 13-14, 1008-1016 p.
Keyword [en]
Traumatic brain injury, paediatric, long-term, outcome, cognitive
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-38550DOI: 10.3109/02699050903379354ISI: 000272556000003OAI: oai:DiVA.org:su-38550DiVA: diva2:310943
Available from: 2010-04-19 Created: 2010-04-19 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Long-term cognitive outcome of childhood traumatic brain injury
Open this publication in new window or tab >>Long-term cognitive outcome of childhood traumatic brain injury
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There is limited knowledge of cognitive outcome extending beyond 5 years after childhood traumatic brain injury, CTBI. The main objectives of this thesis were to investigate cognitive outcome at 6-14 years after CTBI, and to evaluate if advancements in the neurosurgical care, starting 1992, did influence long-term outcome and early epidemiology. An additional aim was to study the relationship between early brain injury parameters and early functional outcome. Study 1 evaluated cognitive progress during 14 years after CTBI, over three neuropsychological assessments in 8 patients with serious CTBI. Study 2 used patient records to investigate early epidemiology, received rehabilitation and medical follow up in two clinical cohorts, n=82 and n=46, treated neurosurgically for CTBI before and after 1992. An exploratory cluster analysis was applied to analyse the relation between early brain injury severity parameters and early functional outcome. In Study 3, participants in the two cohorts, n=18 and n=23, treated neurosurgically for CTBI before and after 1992, were subject to an extensive neuropsychological assessment, 13 and 6 years after injury, respectively. Assessment results of the two cohorts were compared with each other and with controls. Data were analysed with multivariate analyses of variance. Results and discussion. There were significant long-term cognitive deficits of similar magnitude and character in the two cohorts with CTBI, treated before and after the advancements in neurosurgical care. At 6-14 years after injury, long-term deficits in verbal intellectual and executive functions were found, and were discussed in terms of their late maturation and a decreased executive control over verbal memory-functions after CTBI. Visuospatial functions had a slightly better long-term recovery. The amount of rehabilitation received was equally low in both cohorts. The length of time spent in intensive care and the duration of care in the respirator may have a stronger relationship to early outcome than does a single measure of level of consciousness at admission. Main conclusions are that cognitive deficits are apparent at long-term follow up, 6-13 years after neurosurgically treated CTBI, even after advancements in the neurosurgical care in Sweden. Measures of verbal IQ, verbal memory and executive functions were especially low while visuospatial intellectual functions appear to have a better long-term recovery.

Place, publisher, year, edition, pages
Stockholm: Department of Psychology, Stockholm University, 2010. 74 p.
Keyword
traumatic brain injury, childhood, adolescence, neurosurgical care, cognitive development, executive functions, memory, verbal functions, long-term outcome, recovery, rehabilitation, follow-up, cluster analysis
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-38530 (URN)978-91-7447-054-3 (ISBN)
Public defence
2010-05-28, David Magnusson salen (U31), hus 8, Frescati Hagväg 8, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Note
At the time of the doctoral defense, the following paper was unpublished and had a status as follows: Paper 3: Manuscript.Available from: 2010-05-06 Created: 2010-04-18 Last updated: 2011-05-25Bibliographically approved

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