Frontal cerebral vulnerability and executive deficits from raised intracranial pressure in child traumatic brain injury.

Journal of Neurotrauma
Helen SlawikR C Tasker

Abstract

In severe pediatric traumatic brain injury (TBI), a common focus of treatment is raised intracranial pressure (ICP). The aim of this investigation was to test whether raised ICP is associated with later prefrontal executive deficits and regional brain tissue loss, consistent with an anterior vascular compartment syndrome. Thirty-three participants were assigned to one of two severe TBI groups based on whether or not they had increased ICP complicating their critical illness. At follow-up (average 3.9 years), the participants underwent magnetic resonance imaging and a battery of neuropsychological testing focused on prefrontal function. The ICP group had white matter loss that was diffuse as well as regional in the corpus callosum, periventricular tissue, and frontal region. Loss of gray matter in the ICP group was more regionally specific, with bilateral loss in the caudate nuclei and frontal regions, including the right dorsolateral region, right supplementary motor area, and the left orbitofrontal cortex. Both groups had normal intelligence quotients (IQs), but the ICP group showed long-term deficits on various measures of attention and executive function such as working memory, decision-making, and impulsivity. These finding...Continue Reading

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Oct 1, 2011·Medical Science Monitor : International Medical Journal of Experimental and Clinical Research·Maria PachalskaJan Talar
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Software Mentioned

SPSS
SPM5
Statistical Parametric Mapping
ANALYZE
ImageJ
SPM
Statistical Package for Social Sciences ( SPSS )

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