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Neurodevelopmental outcome after severe traumatic brain injury in very young children: role for subcortical lesions.

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Bonnier, Christine [UCL] Marique, Patricia [UCL] Van Hout, Anne Potelle, Dominique

Traumatic brain injury is a major cause of mortality and morbidity in children younger than 15 years of age. To evaluate the role of subcortical lesions on neurodevelopmental outcomes, long-term outcomes of 50 children with severe traumatic brain injury before 4 years of age (accidental injury, n = 21, nonaccidental injury, n = 29) were reviewed retrospectively and compared with late magnetic resonance imaging (MRI) findings: no visible lesions, cortical lesions, or subcortical lesions. Subcortical lesions occurred in both accidental and nonaccidental traumatic brain injuries. Traumatic brain injury severity (initial Glasgow Coma Scale or coma duration) was significantly associated with subcortical lesions. Long-term motor or visual deficiencies occurred in one third of patients and cognitive deficiencies in 52.1%. Although deficiencies occurred without visible MRI lesions, global outcome scores, motor delay, visual impairment, head growth slowing, global intellectual quotients, and planning performances were significantly worse in patients with subcortical lesions. An alarming deterioration in intellectual quotient over time was noted. It was concluded that neurodevelopmental outcomes are worrisome after severe traumatic brain injury in young children, and subcortical lesions affect the prognosis.

Document type Article de périodique (Journal article) – Article de recherche – Journal Article
Access type Accès restreint
Publication date 2007
Language Anglais
Journal information "Journal of Child Neurology" - Vol. 22, no. 5, p. 519-529 (2007)
Peer reviewed yes
Publisher Sage Publications, Inc. ((United States) Thousand Oaks)
issn 0883-0738
e-issn 1708-8283
Publication status Publié
Affiliations UCL - (SLuc) Service de neurologie pédiatrique
UCL - MD/NOPS - Département de neurologie et de psychiatrie
UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie
MESH Subject Adolescent ; Attention - physiology ; Brain Injuries - pathology - physiopathology ; Child ; Child, Preschool ; Cognition - physiology ; Developmental Disabilities - etiology - pathology ; Disability Evaluation ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Humans ; Magnetic Resonance Imaging ; Male ; Motor Activity - physiology ; Neurologic Examination ; Neuropsychological Tests ; Retrospective Studies ; Trauma Severity Indices
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Bibliographic reference Bonnier, Christine ; Marique, Patricia ; Van Hout, Anne ; Potelle, Dominique. Neurodevelopmental outcome after severe traumatic brain injury in very young children: role for subcortical lesions.. In: Journal of Child Neurology, Vol. 22, no. 5, p. 519-529 (2007)
Permanent URL http://hdl.handle.net/2078.1/29441