Citation

Bonnier C, Marique P, Van Hout A, Potelle D. J. Child Neurol. 2007; 22(5): 519-529.

Affiliation

Pediatric Neurology Service, Cliniques Universitaires Saint-Luc, Brussels, Belgium, Centre Neurologique William Lennox, Ottignies-Louvain-la-Neuve, Belgium. bonnier@nepe.ucl.ac.be.

Copyright

(Copyright © 2007, SAGE Publishing)

DOI

10.1177/0883073807302604

PMID

17690056

Abstract

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.

Language: en