TY  - JOUR
PY  - 2008//
TI  - Clinical observation of self-injurious behavior correlated with changes in scalp morphology in a child with congenital hydrocephalus
JO  - Journal of child neurology
A1  - Hartman, Ellie C.
A1  - Gilles, Elizabeth
A1  - McComas, Jennifer J.
A1  - Danov, Stacy E.
A1  - Symons, Frank J.
SP  - 1062
EP  - 1065
VL  - 23
IS  - 9
N2  - We report the case of a 12-year-old girl born with cerebral dysgenesis and congenital hydrocephalus first shunted shortly after birth. She had severe tissue-damaging self-injurious behavior, profound mental retardation, quadriparesis, as well as multiple cranial anomalies including turricephaly. After stage 1 cranial remodeling, a bone window was left pending second stage remodeling. Episodic changes in fluctuation of the scalp overlying the bone window were easily observed. During the course of a behavioral assessment for her self-injury, it was observed that the overall frequency of occurrence of self-injury increased significantly (P < .01) when the scalp was protruding and bulging compared with when the scalp was flush with the skull table. Periods of increased scalp protrusion were also associated with higher scores on a pain scale developed for children with communicative impairments associated with severe neurological impairment. After shunt replacement, there was remarkable improvement in functional status and decreased episodic self-injury.<p />  <p>Language: en</p>
LA  - en
SN  - 0883-0738
UR  - http://dx.doi.org/10.1177/0883073808314155
ID  - ref1
ER  -