title: Traumatic axonal injury and persistent emotional lability in an adolescent following moderate traumatic brain injury: A case study.
abstract: A 15-year-old male was treated secondary to sustaining a moderate traumatic brain injury (moderate TBI). Symptom self-report, and computerized and paper-and-pencil-based neurocognitive, vestibular/ocular motor, and imaging data were used throughout to document impairment and recovery. The patient demonstrated persistent emotional lability concurrent with vestibular impairment. In addition to clinical evaluation and management, the patient also underwent susceptibility-weighted imaging, which revealed axonal shearing across the corpus callosum and areas innervating the prefrontal cortex. Paper-and-pencil neurocognitive measures revealed persisting deficits, despite normal-appearing computerized test results. Implications of this case underline the importance of an integrative evaluation process including clinical interview, neurocognitive and vestibular/ocular physical therapy, and advanced neuroimaging, especially in cases with atypical presentation.
authors.affiliation: a UPMC Sports Medicine Concussion Program/Department of Orthopaedic Surgery , University of Pittsburgh , Pittsburgh , PA , USA.
authors.forename: Luke C
authors.initials: LC
authors.lastname: Henry
authors.forename: Scott O
authors.initials: SO
authors.lastname: Burkhart
authors.forename: R J
authors.initials: RJ
authors.lastname: Elbin
authors.forename: Vikus
authors.initials: V
authors.lastname: Agarwal
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Kontos
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology; D003337:Corpus Callosum / Q000293:injuries*; D020833:Diffuse Axonal Injury / Q000209:etiology* / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D020127:Recovery of Function / Q000502:physiology
keywords: Emotional lability; Moderate traumatic brain injury; Neuroimaging; Neuropsychology; Susceptibility-weighted imaging; Vestibular dysfunction