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Psychosocial outcome of TBI in children with unilateral frontal lesions

Published online by Cambridge University Press:  01 May 2004

HARVEY S. LEVIN
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas Department of Neurosurgery, Baylor College of Medicine, Houston, Texas Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
LIFANG ZHANG
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
MAUREEN DENNIS
Affiliation:
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
LINDA EWING-COBBS
Affiliation:
Department of Pediatrics, University of Texas Health Science Center, Houston, Texas
RUSSELL SCHACHAR
Affiliation:
Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada
JEFFREY MAX
Affiliation:
Department of Psychiatry, University of California San Diego & Children's Hospital and Health Center, San Diego, California
JULIE A. LANDIS
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
GARLAND ROBERSON
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
RANDALL S. SCHEIBEL
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
DAISY L. MILLER
Affiliation:
Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
JILL V. HUNTER
Affiliation:
Department of Radiology, Baylor College of Medicine, Houston, Texas

Abstract

To evaluate effects of unilateral frontal lesions on psychosocial and global outcome of traumatic brain injury (TBI) in children, Study 1 compared matched groups of 22 school aged children who had sustained TBI either with or without unilateral frontal lesions. Study 2 evaluated effects of unilateral extrafrontal lesions in 18 TBI patients as compared with 18 nonlesional TBI patients. Communication, Daily Living, and Socialization domains and the Maladaptive Behavior Scale of the Vineland Adaptive Behavior Scales (VABS) were used to assess psychosocial outcome, and the Glasgow Outcome Scale (GOS) measured global outcome. All patients underwent magnetic resonance imaging at least 3 months post injury. Children with frontal lesions had worse scores on the Daily Living and Socialization domains and a higher frequency of maladaptive behavior than those without frontal lesions, but there was no difference in cognitive function. Disability was twice as common in the frontal lesion group relative to children without frontal lesions. Volume of frontal lesion was related to the Socialization domain. Side of lesion had no effect, nor did presence of an extrafrontal lesion (Study 2). Unilateral frontal lesions adversely affect late psychosocial outcome of TBI in children. (JINS, 2004, 10, 305–316.)

Type
Research Article
Copyright
© 2004 The International Neuropsychological Society

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