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Neuropsychological progress during 14 yearsafter severe traumatic brain injury in childhoodand adolescence
Stockholm University, Faculty of Social Sciences, Department of Psychology.
Department of Psychology, Gothenburg University, Sweden.
Institute for the Health of Women and Children, Sahlgrenska Academy at Göteborg.
2004 (English)In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 18, no 9, 921-934 p.Article in journal (Refereed) Published
Abstract [en]

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 neuropsychological at one, seven and 14 years after TBI. A retrospective longitudinal design was chosen to describe the development in six neuropsychological domains on basis of the assessments. Psychosocial data were gathered from clinical knowledge and a semi-structured interview at 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 go from a school situation with no adjustments to adult life with an 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.

Place, publisher, year, edition, pages
Taylor & Francis , 2004. Vol. 18, no 9, 921-934 p.
Keyword [en]
traumatic brain injury, childhood, cognitive development, long-term outcome
National Category
Psychology
Research subject
Psychology
Identifiers
URN: urn:nbn:se:su:diva-38554DOI: 10.1080/02699050410001671900OAI: oai:DiVA.org:su-38554DiVA: diva2:310950
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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