Neuropsychological outcome of children with traumatic brain injury and its association with late magnetic resonance imaging findings: A cohort study

• Published in: Brain injury Vol. 31; no. 12; pp. 1689 - 1694
• Main Authors: Volpe, Daniele S. J., Oliveira, Nátali C. A. C, Santos, A. Carlos, Linhares, Maria B. M., Carlotti, Ana P. C. P.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 15-10-2017
• Subjects: Adolescent; Brain Injuries, Traumatic - complications; Brain Injuries, Traumatic - diagnostic imaging; Child; Cognition Disorders - etiology; Cohort Studies; Female; Fractional anisotropy; Glasgow Coma Scale; head injury; Humans; Image Processing, Computer-Assisted; Magnetic Resonance Imaging; Male; Neuropsychological Tests; neuroradiological abnormalities; prognosis; psychometric indexes; Statistics, Nonparametric; trauma; Wechsler Scales; trauma; Fractional anisotropy; psychometric indexes; head injury; prognosis; neuroradiological abnormalities
• ISSN: 0269-9052; 1362-301X
• DOI: 10.1080/02699052.2017.1358398

Objectives: To evaluate neuropsychological outcome after traumatic brain injury (TBI) and its association with trauma severity and late magnetic resonance imaging (MRI) findings.
Methods: Prospective cohort study of patients with TBI admitted to the paediatric intensive care unit over 5 years. Trauma severity was determined by Glasgow Coma Scale (GCS), neurological outcome by King's Outcome Scale for Childhood Head Injury (KOSCHI) and neuropsychological outcome by Wechsler Intelligence Scale for Children - Fourth Edition.
Results: Twenty-five children (median age 6 years at trauma) were included. Patients were divided into Disability (DIS)(n = 10) and Good Recovery (GR)(n = 15) groups. Initial GCS score was not significantly different in both groups (median 6 vs. 10; p = 0.34). DIS group had lower values ​​of working memory index (WMI)(median 74 vs. 94; p = 0.004), perceptual reasoning index (PRI)(75 vs. 96; p = 0.03), verbal comprehension index (VCI)(65 vs. 84; p = 0.02), processing speed index (PSI)(74 vs. 97; p = 0.01) and full-scale intelligence quotient (FSIQ)(65 vs. 87; p = 0.008). In the GR group, 60% of patients had normal or minimally altered MRI versus 10% of patients in the DIS group (p = 0.018). Fractional anisotropy positively correlated with WMI(r = 0.65; p = 0.005), PRI(r = 0.52; p = 0.03) and FSIQ(r = 0.50; p = 0.04).
Conclusions: Neuropsychological impairment was observed in 40% of children who suffered a TBI and was associated with late MRI abnormalities.