title: Psychosocial outcome of TBI in children with unilateral frontal lesions.
abstract: To evaluate effects of unilateral frontal lesions on psychosocial and global outcome of traumatic brain injury (TBI) in children, Study 1 compared matched groups of 22 school aged children who had sustained TBI either with or without unilateral frontal lesions. Study 2 evaluated effects of unilateral extrafrontal lesions in 18 TBI patients as compared with 18 nonlesional TBI patients. Communication, Daily Living, and Socialization domains and the Maladaptive Behavior Scale of the Vineland Adaptive Behavior Scales (VABS) were used to assess psychosocial outcome, and the Glasgow Outcome Scale (GOS) measured global outcome. All patients underwent magnetic resonance imaging at least 3 months post injury. Children with frontal lesions had worse scores on the Daily Living and Socialization domains and a higher frequency of maladaptive behavior than those without frontal lesions, but there was no difference in cognitive function. Disability was twice as common in the frontal lesion group relative to children without frontal lesions. Volume of frontal lesion was related to the Socialization domain. Side of lesion had no effect, nor did presence of an extrafrontal lesion (Study 2). Unilateral frontal lesions adversely affect late psychosocial outcome of TBI in children.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas 77030, USA. hlevin@bcm.tmc.edu
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
authors.forename: Lifang
authors.initials: L
authors.lastname: Zhang
authors.forename: Maureen
authors.initials: M
authors.lastname: Dennis
authors.forename: Linda
authors.initials: L
authors.lastname: Ewing-Cobbs
authors.forename: Russell
authors.initials: R
authors.lastname: Schachar
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Max
authors.forename: Julie A
authors.initials: JA
authors.lastname: Landis
authors.forename: Garland
authors.initials: G
authors.lastname: Roberson
authors.forename: Randall S
authors.initials: RS
authors.lastname: Scheibel
authors.forename: Daisy L
authors.initials: DL
authors.lastname: Miller
authors.forename: Jill V
authors.initials: JV
authors.lastname: Hunter
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000293:injuries* / Q000473:pathology; D007839:Functional Laterality; D015600:Glasgow Coma Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012917:Social Adjustment; D015599:Trauma Severity Indices