[Evaluation of diffuse cerebral atrophy in patients with a history of traumatic brain injury and its relation to cognitive deterioration].
BACKGROUND
Diffuse damage secondary to traumatic brain injury (TBI) can be studied through volumetric analysis of several structures that are sensible to this kind of injury, such as corpus callosum, ventricular system, hippocampus, basal ganglia and the volume of cerebrospinal fluid spaces.


OBJECTIVE
Our aim is to describe how closed head injury (CHI) occurred in early years produce diffuse damage, and how this damage affects general cognitive functioning at long term.


METHODS
Initially the group of subjects was composed of 27 head injured children and adolescents following paediatric moderate to severe TBI. From this initial group we selected 15 patients without focal lesion, or in case of having suffered focal lesion, this was smaller than 2,600 mm3. These subjects were assessed by means of volumetric analysis of cerebrospinal fluid spaces, corpus callosum, hippocampus and caudate nucleus, comparing the results with a matched control group. We calculated the degree of general cognitive ability of these subjects through tests of intellectual, memory, frontal lobe and motor speed functioning.


RESULTS
This study demonstrates that early CHI produce a volume decrease in all measured structures. Corpus callosum atrophy is the factor that better explains general cognitive impairment.


CONCLUSIONS
Diffuse damage secondary to moderate to severe peadiatric TBI has long term effects on several cerebral structures and on cognitive performance. Corpus callosum atrophy is the best predictor for general cognitive impairment, compared with other affected structures.
Narberhaus
A
A
Universitat de Barcelona. Facultat de Psicologia, Barcelona, España.
Segarra-Castells
M D
MD
Verger-Maestre
K
K
Serra-Grabulosa
J M
JM
Salgado-Pineda
P
P
Bartomeus-Jené
F
F
Mercader-Sobrequés
J M
JM
D000293:Adolescent; D001284:Atrophy / Q000473:pathology; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications* / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D003337:Corpus Callosum / Q000473:pathology; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D009483:Neuropsychological Tests