Thirty month outcome from early childhood head injury: a prospective analysis of neurobehavioural recovery
Thirty month outcome from early childhood head injury: a prospective analysis of neurobehavioural recovery
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DOI：
10.1093/brain/awh320
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发表时间：
2004-12-01
期刊：
影响因子：
14.5
通讯作者：
Rosenfeld, JV
中科院分区：
文献类型：
--
作者：
Anderson, VA;Morse, SA;Rosenfeld, JV
创伤性脑损伤（TBI）是儿童时期获得性残疾的常见原因。虽然现在对学龄人口TBI后的结果了解很多，但婴儿和幼儿的康复情况却缺乏充分的记录。本研究的目的是检查幼儿期TBI后的神经行为功能，绘制受伤后30个月的恢复情况，并确定结果的预测因素。该研究比较了三组儿童，不同严重程度的损伤（轻度= 14，中度= 46，重度= 24），年龄2.0-6.11岁的伤害，与健康对照组（n = 33）。各组在伤前适应和行为功能、心理社会特征、年龄和性别方面相似。采用前瞻性、纵向设计，研究了急性损伤后以及损伤后12个月和30个月时的智力、语言和记忆功能。结果表明，在所有神经行为领域的损伤严重程度之间有很强的关联。此外，30个月的结果是由多种因素预测的，包括损伤严重程度，社会经济地位，损伤前的适应能力和年龄，与损伤前的儿童行为和具体病变特征发挥的作用令人惊讶的小。总之，受伤较严重、受伤前适应能力较低和社会经济地位较低的儿童发生长期神经行为障碍的风险最大，甚至在受伤后几年。
Traumatic brain injury (TBI) is a common cause of acquired disability during childhood. While much is now known about outcome following TBI in the school-aged population, recovery in infants and young children is less well documented. The aim of this study was to examine neurobehavioural function following TBI during early childhood, to plot recovery over the 30 months post-injury and to identify predictors of outcome. The study compared three groups of children, sustaining injuries of different severity (mild = 14, moderate = 46, severe = 24), aged 2.0-6.11 years at injury, with a healthy control group (n = 33). The groups were similar with respect to pre-injury adaptive and behavioural function, psychosocial characteristics, age and gender. Using a prospective, longitudinal design, intellectual, language and memory functions were investigated acutely post-injury and again at 12 and 30 months post-injury. Results suggested a strong association between injury severity across all neurobehavioural domains. Further, 30 month outcome was predicted by multiple factors including injury severity, socio-economic status, pre-injury adaptive abilities and age, with pre-injury child behaviour and specific lesion characteristics playing surprisingly little role. In conclusion, children with more severe injuries, lower pre-injury adaptive abilities and lower socio-economic status are at greatest risk of long-term neurobehavioural impairment, even several years post-injury.