摘要:

Objective:To examine the incidence and neuropsychological, behavioral, and neuroimaging correlates of postconcussive symptoms (PCS) in children with mild closed head injuries (CHI).Design:26 Children with mild CHI and 8 of their uninjured siblings, from 8 to 15 years old, were recruited prospectively and assessed at baseline (ie, within 7 days of injury) and at 3 months postinjury. Parents rated PCS, motivation and affective lability, and behavioral adjustment. Baseline ratings assessed premorbid functioning retrospectively, and follow-up ratings assessed postinjury status. On both occasions, children completed neuropsychological testing, and those with mild CHI also underwent magnetic resonance imaging (MRI).Results:Children with mild CHI did not differ from siblings in baseline ratings of premorbid PCS but displayed higher ratings on several PCS at 3 months postinjury. Thirty-five percent of children with mild CHI showed increases in PCS, compared with baseline premorbid ratings, but none of the siblings did so. Children with mild CHI whose PCS increased from premorbid levels showed poorer neuropsychological functioning at baseline than did children whose PCS did not increase, although the differences had partially resolved by 3 months. They also displayed decreased motivation over time. Their behavioral adjustment was poorer and they had smaller white matter volumes on MRI, but the latter differences were present at baseline and did not change over time, suggesting that they existed prior to the injury.Conclusion:Postinjury increases in PCS occur in a sizable minority of children with mild CHI and more often than among uninjured siblings. Increases in PCS following mild CHI are associated with premorbid neurological and psychosocial vulnerability, but also with postinjury decrements in neuropsychological and neurobehavioral functioning.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:To examine the neurobehavioral status of children with traumatic head injury (THI) and to identify variables that predict outcome.Design:Retrospective chart review, with follow-up 1–5 years after injury. Outcome predictor variables were identified through stepwise regression analysis.Setting:Level one trauma center and pediatric rehabilitation program.Patients:71 Children with THI, selected from a four-year series of consecutive admissions.Measure:Vineland Adaptive Behavior Scales—Survey Edition.Results:Significant predictors of better neurobehavioral status at follow-up included absence of a premorbid learning problem (p< .01), older age at injury (p< .01), and normal pupillary response (p< .001) and higher cerebral perfusion pressure (p< .0001) during critical care management.Conclusions:Neurobehavioral outcome after THI is influenced by premorbid psychosocial variables as well as by critical care management.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objectives:To investigate outcome in children with mild traumatic head injury (THI) at 1 week and 3 months postinjury and to identify factors associated with persisting problems.Design:Postconcussional symptomatology, behavior ratings, and neuropsychological test performance were examined at 1 week and 3 months postinjury.Setting:Participants were recruited from successive presentations to emergency departments of two major hospitals.Participants:130 Children with mild THI were compared with 96 children having other minor injuries as controls.Results:Children with mild THI experienced headaches, dizziness, and fatigue but exhibited no cognitive impairments, relative to controls, at 1 week postinjury. By 3 months, symptoms had resolved. However, 17% of children showed significant ongoing problems. They were more likely to have a history of previous head injury, learning difficulties, neurological or psychiatric problems, or family stressors.Conclusions:Persisting problems following mild head injury in children are more common in those with previous head injury, preexisting learning difficulties, or neurological, psychiatric, or family problems. These “at-risk” children should be identified in the emergency department and monitored.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

This article examines the empirical support for psychological therapies for children with traumatic brain injury (TBI). Empirical support for psychological treatments of noninjured children provides a foundation upon and a framework in which to discuss applications to children with neurobehavioral dysfunction. Behavioral interventions to address externalizing behaviors have received the greatest focus, whereas there is a paucity of work that pertains to internalizing features and prosocial behavior such as assertiveness. Although the systematic study of psychological intervention lags far behind the rapidly increasing knowledge of neurobehavioral sequelae to TBI, there are promising directions that stem from initial findings.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Family-centered rehabilitation programs are derived from a philosophy of heath care delivery known asfamily-centered care. The principles of family-centered care are presented with clinical examples. Its origins are reviewed, and the 10-year process of implementation of family-centered care practice and policy at a children's rehabilitation center are described. Profound changes in behavior are required of the health care professionals as meaningful collaboration with families develops. Key elements of a family-centered rehabilitation program include meaningful participation by families in medical decision making and an institutional culture flexible enough to respond to the ongoing collaboration between families and practitioners.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Objective:To assess the reliability and validity of a new instrument, the Family Burden of Injury Interview (FBII) was designed to assess the impact of childhood traumatic head injuries (THI) on the family.Participants:99 Mothers of school-age children who experienced THI.Results:The FBII Total Score revealed group differences between families of children with severe THI and families of children with moderate THI. The measure also showed concurrent and predictive relationships to measures of the general impact of injury on families and maternal and child functioning.Conclusion:The FBII is a promising tool for measuring the impact of injury-related stressors on the family.

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Contemporary neuorimaging techniques in child traumatic brain injury are reviewed, with an emphasis on computerized tomography (CT) and magnetic resonance (MR) imaging. A brief overview of MR spectroscopy (MRS), functional MR imaging (fMRI), single-photon emission computed tomography (SPECT), and magnetoencephalography (MEG) is also provided because these techniques will likely constitute important neuroimaging techniques of the future. Numerous figures are provided to illustrate the multi-faceted manner in which traumatic deficits can be imaged and the role of neuroimaging information as it relates to TBI outcome

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0885-9701    

出版商:OVID    

年代:1999

数据来源: OVID