Neurobehavioral Outcome After Closed Head Injury in Childhood and Adolescence

Filley, Christopher M.; Cranberg, Lee D.; Alexander, Michael P.; Hart, Edward J.

doi:10.1001/archneur.1987.00520140058018

Cited by 91 publications

(33 citation statements)

References 25 publications

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“…This is contrary to other many studies that have examined predictors of outcome in older children after TBI, in which it was found that younger children have a poorer outcome. 33,34 One other study recently found age not to be predictive of outcome in young children, and here the authors comment that their findings are "contrary to expectations." 35 A larger study is required to confirm our findings that age does not seem to influence outcome within the subpopulation of inflicted TBI.…”

Section: E182mentioning

confidence: 57%

Late Neurologic and Cognitive Sequelae of Inflicted Traumatic Brain Injury in Infancy

Barlow

Thomson

Johnson³

et al. 2005

Pediatrics

301

175

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ABSTRACT.Objective. There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population.Methods. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales.Results. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: ؎25.

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Section: E182mentioning

confidence: 57%

Late Neurologic and Cognitive Sequelae of Inflicted Traumatic Brain Injury in Infancy

Barlow

Thomson

Johnson³

et al. 2005

Pediatrics

301

175

View full text Add to dashboard Cite

show abstract

“…Although some studies examining functional/neurobehavioral outcome in age-based cohorts of children and adolescents following nonpenetrating brain injury did not identify relationships with age [1, 2, 3, 4, 5], the majority of studies report less favorable rates of mortality and morbidity in infants and preschoolers than in school-age children and adolescents [6, 7, 8, 9, 10, 11, 12, 13, 14]. …”

Section: Introductionmentioning

confidence: 99%

“…Increasing injury severity as reflected in lower GCS scores and increasing duration of impaired consciousness or post-traumatic amnesia is generally associated with decreasing functional competence at the time of discharge [24]as well as 6 months to several years after injury in pediatric populations [6, 13, 25]. Both the total GCS score and the component scores have been significantly related to outcome during early [5]and late stages of recovery [25, 26].…”

Section: Introductionmentioning

confidence: 99%

Predictors of Outcome following Traumatic Brain Injury in Young Children

et al. 2002

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The relationship between clinical and neuroimaging variables and multiple outcome measures was examined in a longitudinal, prospective study of 60 children less than 6 years of age who sustained either inflicted or noninflicted traumatic brain injury. Hierarchical multiple regression indicated that the modified Glasgow Coma Scale score, the duration of impaired consciousness and the number of intracranial lesions visualized on CT/MRI accounted for a significant amount of the variance in the Glasgow Outcome Scale (GOS), cognitive and motor scores at baseline, 3- and 12-month evaluations. Inflicted brain injury adversely affected both GOS and cognitive outcomes. Pupillary abnormalities were associated with poorer motor outcome. Neither age at injury nor the Injury Severity Score accounted for significant variability in outcomes.

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“…The GOS was used as the endpoint of evaluation because GOS levels of 3–5 have correlated with detailed neuropsychological evaluation years after injury [28, 29]. Outcome at discharge was considered adequate to identify patients with unfavourable outcome in the light of the report by Filley et al [29]that no child with coma lasting more than 1 month or in persistent vegetative state improved to good outcome by any criteria.…”

Section: Discussionmentioning

confidence: 99%

“…Outcome at discharge was considered adequate to identify patients with unfavourable outcome in the light of the report by Filley et al [29]that no child with coma lasting more than 1 month or in persistent vegetative state improved to good outcome by any criteria. Children with severe disability were included in the favourable outcome group because such children have been reported to improve to good recovery and moderate disability by 2 years according to the Lidcombe Impairment Scale [5].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Children with Severe Diffuse Brain Injuries: A Study of 74 Patients

Pillai¹,

Praharaj²,

Mohanty³

et al. 2001

Pediatr Neurosurg

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Severe diffuse brain injury in children has a devastating influence on their physical and psychological development. This retrospective study was undertaken to analyse the factors that influence outcome in children with such injuries. The short-term outcomes (Glasgow outcome score) of 74 children (age ≤15 years) with severe diffuse brain injury and no focal operable mass lesions on CT scan, admitted between 1992 and 1998 at the National Institute of Mental Health and Neurosciences were analysed. The prognostic factors analysed were age, gender, time after injury to admission, nature of injury, highest post-resuscitation Glasgow coma score (GCS), pupillary reaction, horizontal oculocephalic reflex and CT scan findings. The following factors were found to be independent predictors of poor outcome: GCS 3–5 (p < 0.003), absent verbal response (p < 0.001), motor response score of 1–3 (p < 0.001), absent pupillary reaction (p < 0.001), absent oculocephalic reflex (p < 0.001) and presence of traumatic subarachnoid haemorrhage on CT scan (p < 0.002). These independent variables were then subjected to a stepwise logistic regression analysis, and the most important variables for predicting outcome were oculocephalic reflex and GCS, which together correctly predicted unfavourable outcome with a sensitivity of 79% and a specificity of 65%. An early CT scan or a single CT scan did not have any prognostic significance.

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Neurobehavioral Outcome After Closed Head Injury in Childhood and Adolescence

Cited by 91 publications

References 25 publications

Late Neurologic and Cognitive Sequelae of Inflicted Traumatic Brain Injury in Infancy

Late Neurologic and Cognitive Sequelae of Inflicted Traumatic Brain Injury in Infancy

Predictors of Outcome following Traumatic Brain Injury in Young Children

Prognostic Factors in Children with Severe Diffuse Brain Injuries: A Study of 74 Patients

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