Cognitive recovery after severe traumatic brain injury in children/adolescents and adults: Similar positive outcome but different underlying pathways?

Rehabilitation Care of the Child with an Acute Severe Traumatic Brain Injury

Children with traumatic brain injury (TBI) represent a unique and evolving population. Recovery and long-term prognosis are variable given the heterogeneity of ages, developmental stages, and types of injuries. This article summarizes important information regarding severe TBI epidemiology, pathophysiology, classification, and acute management. Early and longitudinal involvement of rehabilitation experts, such as pediatric physiatrists, is critical in managing complications and optimizing outcomes.

Memory functioning 7 years after severe childhood traumatic brain injury: Results of the Traumatisme Grave de l'Enfant study

OBJECTIVE

To explore memory functioning 7 years after severe paediatric traumatic brain injury (TBI), associated factors, and relationships with other outcomes.

METHOD

Children aged 0-15 years (n = 65), consecutively admitted over a 3-year period in a single trauma centre, who survived after severe non-inflicted TBI, were included in a prospective longitudinal study. Memory assessments were performed 7 years post-injury using the Children's Memory Scale or the Wechsler Memory Scale (WMS IV), according to age. The General Memory Score (GMS-7) was the primary outcome.

RESULTS

Thirty-seven patients were available for assessment at 7 years post-injury. Mean GMS-7 was in the low average range (M = 84.9, SD = 12.1). Lower GMS-7 was significantly associated with markers of higher injury severity, such as length of coma. One year post-injury functional and disability outcomes explained 74% of the variance of GMS-7. Concurrent intellectual ability and type of ongoing education correlated strongly with GMS-7. Age at injury and parental education were not associated with memory outcome.

CONCLUSIONS

Memory functioning is variable but often strongly impaired several years after severe paediatric TBI, and is mostly related to injury severity, functional outcomes measured 1 year post-injury, and concomitant cognitive and educational outcomes. GMS-7 was lower at 7 years than one year post-injury, supporting the importance of long term follow-up.

Assessment of memory functioning over two years following severe childhood traumatic brain injury: results of the TGE cohort

The aims of this study were (1) to prospectively measure memory functioning following severe childhood Traumatic Brain Injury (TBI), and its evolution over 2 years; (2) to assess demographic and medical factors associated with memory function and recovery; (3) to explore relations between memory and other TBI outcomes. Methods: Children (aged 0-15 years; n= 65) consecutively admitted in a single trauma center over a 3-year period, who survived severe non-inflicted TBI, were included in a prospective longitudinal study. Memory was assessed in 38 children aged 5-15 years at injury, using the Children's Memory Scale at 3, 12, and 24 months post-injury. Results: Mean general memory score was low at 3 months (M = 90.2, SD = 20.3) but within the normal range at 12 and 24 months (M = 100.6, SD = 23.1 and M = 108.6, SD = 24.1, respectively), with high variability. Improvement was stronger for immediate visual memory than for other memory indices. Lower general memory score was associated with higher injury severity, lower intellectual ability and functional status, higher overall disability, and ongoing education. Conclusion: Memory functioning is highly variable following severe childhood TBI, related to injury severity and functional, cognitive and educational outcomes; improvement is significant during the first-year post-injury, but varies according to the type of memory.

Investigating metacognition, cognition, and behavioral deficits of college students with acute traumatic brain injuries

OBJECTIVE

Executive dysfunction in college students who have had an acute traumatic brain injury (TBI) was investigated. The cognitive, behavioral, and metacognitive effects on college students who endorsed experiencing a brain injury were specifically explored.

PARTICIPANTS

Participants were 121 college students who endorsed a mild TBI, and 121 college students with no history of a TBI were matched on sex and ethnicity to examine potential differences between groups.

METHODS

Participants completed the Dysexecutive Questionnaire (DEX).

RESULTS

A Rasch analysis indicated that the TBI group had significantly higher total scores on the DEX than the control group. Moreover, when compared with the control group, the students with a TBI had higher scores on all 3 subcomponents of the DEX.

CONCLUSION

These findings suggest that students who endorse brain injuries may experience more difficulty with specific facets of college. Thus, the importance of academic and personal resources available for students with a TBI is discussed.