Neuropsychological consequences of traumatic brain injury in children and adolescents

Occurrence of early epilepsy in children with traumatic brain injury: a retrospective study

BACKGROUND

Early post-traumatic seizures (EPTS) refer to epileptic seizures occurring within one week after brain injury. This study aimed to define the risk factors of EPTS and the protective factors that could prevent its occurrence.

METHODS

This is a single-center retrospective study in the PICU, Beijing Children's Hospital. Patients diagnosed with traumatic brain injury (TBI), admitted with and without EPTS between January 2016 and December 2020 were included in the study.

RESULTS

We included 108 patients diagnosed with TBI. The overall EPTS incidence was 33.98% (35/108). The correlation between EPTS and depressed fractures is positive (P = 0.023). Positive correlations between EPTS and intracranial hemorrhage and subarachnoid hemorrhage had been established (P = 0.011and P = 0.004, respectively). The detection rates of EPTS in the electroencephalogram (EEG) monitoring was 80.00%. There was a significant difference in the EEG monitoring rate between the two groups (P = 0.041). Forty-one (37.86%, 41/108) post-neurosurgical patients were treated with prophylactic antiepileptic drugs (AEDs), and eight (19.51%, 8/41) still had seizures. No statistical significance was noted between the two groups in terms of prophylactic AEDs use (P = 0.519). Logistic regression analysis revealed that open craniocerebral injury and fever on admission were risk factors for EPTS, whereas, surgical intervention and use of hypertonic saline were associated with not developing EPTS.

CONCLUSIONS

Breakthrough EPTS occurred after severe TBI in 33.98% of pediatric cases in our cohort. This is a higher seizure incidence than that reported previously. Patients with fever on admission and open craniocerebral injuries are more likely to develop EPTS.

Trends in North American newspaper reporting of brain injury in ice hockey

The frequency and potential long-term effects of sport-related traumatic brain injuries (TBI) make it a major public health concern. The culture within contact sports, such as ice hockey, encourages aggression that puts youth at risk of TBI such as concussion. Newspaper reports play an important role in conveying and shaping the culture around health-related behaviors. We qualitatively studied reports about sport-related TBI in four major North American newspapers over the last quarter-century. We used the grounded-theory approach to identify major themes and then did a content analysis to compare the frequency of key themes between 1998–2000 and 2009–2011. The major themes were: perceptions of brain injury, aggression, equipment, rules and regulations, and youth hockey. Across the full study period, newspaper articles from Canada and America portrayed violence and aggression that leads to TBI both as integral to hockey and as an unavoidable risk associated with playing the game. They also condemned violence in ice hockey, criticized the administrative response to TBI, and recognized the significance of TBI. In Canada, aggression was reported more often recently and there was a distinctive shift in portraying protective equipment as a solution to TBI in earlier years to a potential contributing factor to TBI later in the study period. American newspapers gave a greater attention to ‘perception of risks’ and the role of protective equipment, and discussed TBI in a broader context in the recent time period. Newspapers from both countries showed similar recent trends in regards to a need for rule changes to curb youth sport-related TBI. This study provides a rich description of the reporting around TBI in contact sport. Understanding this reporting is important for evaluating whether the dangers of sport-related TBI are being appropriately communicated by the media.

Demographic and injury-related moderators of memory and achievement outcome in pediatric TBI

Critical factors affecting traumatic brain injury (TBI) outcome in children and adolescents are explored with an emphasis on an examination of age at injury as a predictor of memory functioning. Age at injury and other injury-related and demographic predictors (i.e., severity, time postinjury, gender, and socioeconomic status [SES]) of memory and achievement outcome were examined in 65 children and adolescents post-TBI compared to 65 age-matched noninjured controls. Although robust findings have been found for age at injury as a general predictor of outcome, age was not found to be a significant predictor of memory functioning following pediatric TBI. Structural equation modeling suggests that the most parsimonious model of post-TBI outcome contains two causally related latent variables: one defined by gender, SES, injury severity, and age at injury, and one defined by general cognitive functioning.

The unique features of traumatic brain injury in children. Review of the characteristics of the pediatric skull and brain, mechanisms of trauma, patterns of injury, complications and their imaging findings--part 1

Traumatic head/brain injury (TBI) is a leading cause of death and life-long disability in children. The biomechanical properties of the child's brain and skull, the size of the child, the age-specific activity pattern, and higher degree of brain plasticity result in a unique distribution, degree, and quality of TBI compared to adult TBI. A detailed knowledge about the various types of primary and secondary pediatric head injuries is essential to better identify and understand pediatric TBI. The goals of this review article are (1) to discuss the unique epidemiology, mechanisms, and characteristics of TBI in children, and (2) to review the anatomical and functional imaging techniques that can be used to study common and rare pediatric traumatic brain injuries and their complications.

The effects of mild traumatic brain injury on confrontation naming in adults

PRIMARY OBJECTIVE

To compare confrontation-naming in adults with MTBI to a group of normal adults under increased processing load conditions.

RESEARCH DESIGN

A randomized block, repeated measures design was used to examine confrontation-naming response latency and accuracy using a computerized experimental program.

METHODS AND PROCEDURES

Twenty-four adults having sustained a MTBI (aged 18-53) and 24 age-matched controls named pictures from three levels of vocabulary as quickly and accurately as possible. All MTBI participants were assessed with the Scales of Cognitive Ability for Traumatic Brain Injury (SCATBI) for later comparison.

MAIN OUTCOMES AND RESULTS

The results revealed a main effect of group ( p < or = 0.001) for the latency data and a group by vocabulary level interaction ( p = 0.043) for the accuracy data. No significant correlations were found between response latency and accuracy with performance on the SCATBI. Reaction time measures may reveal inefficiencies not tapped by traditional measures.

The Influence of an Auditory Distraction on Rapid Naming After a Mild Traumatic Brain Injury: A Longitudinal Study

OBJECTIVE

The purpose of this investigation was to examine speeded performance over time and the impact of a common auditory distraction on performance after a mild traumatic brain injury (MTBI).

METHODS

Fourteen adults (ages 18-53) treated for a MTBI and 14 age and education-matched controls were asked to perform two speeded naming tasks. Both tasks were presented with or without the presence a common auditory distraction. The MTBI group was tested within 5 days, 30 days, 60 days, and 6 months postinjury. Latency (ms) and accuracy of response were recorded.

RESULTS

Initially, the MTBI group demonstrated significantly longer response latencies and lower accuracy levels for both tasks. Similar results were found at 30 days postinjury. At 60 days postinjury, no significant difference was found for task 1 accuracy. Significant differences remained for task 1 latency, task 2 latency, and task 2 accuracy. At 6 months postinjury, no significant differences were found. The presence of an auditory distraction differentially affected the MTBI group for task 2 accuracy upon initial testing and at 30 days postinjury only.

CONCLUSIONS

The MTBI group performed both tasks significantly slower and less accurately than the control group upon initial testing and at 30 days postinjury. The presence of pop music further influenced accuracy of complex processing. At 60 days postinjury, accuracy of simple processing returned to preinjury levels and the auditory distraction no longer differentially influenced the MTBI group. All performance differences were resolved at 6 months postinjury.

The role of functional neuroimaging in pediatric brain injury

The aim of this article is to review empirical studies published in the last 10 years that used various functional neuroimaging techniques to assess pediatric patients with brain injury. Overall, these studies have demonstrated the ability of functional neuroimaging to offer unique information concerning the diagnosis, clinical outcome, and recovery mechanisms after pediatric brain injury. Future research using functional neuroimaging is recommended to better understand the functional reorganization and neurodevelopmental consequences resulting from brain injury. Such research might allow clinicians to design tailored early-intervention and rehabilitation programs to maximize the recovery process for pediatric patients. Limitations and advantages associated with the use of functional neuroimaging in pediatric populations are discussed.

Can within-category naming identify subtle cognitive deficits in the mild traumatic brain-injured patient?

BACKGROUND

This investigation examined the effect of a speeded, computer-controlled task on detecting differences in latency and accuracy of within-category name generation in adults having sustained a mild traumatic brain injury (MTBI).

METHODS

Twenty-four adults in acute recovery and 24 age-matched controls were instructed to view 72 pictures on a computer monitor, and then name another item belonging to the same category as the visual stimulus as quickly as possible.

RESULTS

The MTBI group demonstrated significantly longer latencies (p < 0.001) and lower accuracy (p < 0.001) than the control group. Both groups displayed similar patterns of response, although the MTBI group produced significantly more perseverative errors (p < 0.001). No significant correlations were found between performance on the Scales of Cognitive Ability for Traumatic Brain Injury and response latency or accuracy.

CONCLUSION

The MTBI group performed the task significantly slower and less accurately than controls. Reaction time measures may prove more sensitive than traditional assessment measures in detecting subtle difficulties.

TBI knowledge and pragmatic assessment among Connecticut school speech-language pathologists

School-based speech-language pathologists from Connecticut responded to a random survey which had a twofold purpose, (1) to replicate a previous conclusion that clinicians' specific experience with traumatic brain injury (TBI) influences their knowledge of this subject, and (2) to explore the topic of pragmatic assessment and whether it is also influenced by specific TBI experience. Results indicate that Connecticut school clinicians favourably regard both their own knowledge of TBI and the contemporary issue of pragmatic assessment. Connecticut clinicians also report a relatively low degree of prior TBI training and clinical experience. Clinicians' degree of TBI training and clinical experience did not appear directly related to their reported competence in TBI knowledge and pragmatic assessment.