trauma brain frontal prognosis child

The incidence of borderline personality disorder (BPD) in psychiatric care has shown growing tendencies. Despite its frequency, it is an underdiagnosed disease. Profound knowledge of etiological factors of BPD is essential for the proper diagnosis and treatment. The present study aims to provide a developmental psychopathological analysis of borderline personality disorder, which includes a thorough review of genetic and environmental etiological factors, an introduction to the functionalist approach of evolutionary perspective, and an overview of age specific characteristics of borderline symptoms...

PURPOSE: The broad spectrum of frontal bone fractures, including those with orbital and skull base extension, is poorly understood. We propose a novel classification scheme for frontal bone fractures. METHODS: Maxillofacial CT scans of trauma patients were reviewed over a five year period, and frontal bone fractures were classified: Type 1: Frontal sinus fracture without vertical extension. Type 2: Vertical fracture through the orbit without frontal sinus involvement...

The Kleine-Levin syndrome (KLS) is a rare disease which can occur one to several times per year. The KLS belongs to the group of hypersomnia of central origin occurring mainly during the second decade of life after infections, sleep deprivation, alcohol consumption or minor trauma. Early manifestation combined with hypersexuality during symptomatic phases can be a predictor for a long course of the disease, which lasts a mean of 1-27 years. Due to the lack of biological markers diagnosis at first manifestation is difficult...

AIM: To evaluate the apparent diffusion coefficient (ADC) values for predicting the long-term neurodevelopmental outcomes of patients with abusive head trauma (AHT). METHODS: Apparent diffusion coefficient maps were retrospectively reviewed for 14 patients who presented with AHT at a mean age of 6.7 months (range 1-18 months), and the clinical outcomes of the survivors were based on the Glasgow Outcome Score. RESULTS: One of 14 infants died, and two were severely disabled...

OBJECTIVE: This study was undertaken to assess the clinical and radiological characteristics of children with traumatic extradural hematoma (TEDH), and factors affecting the initial neurological status and outcome. METHODS: Medical records of 269 consecutive children with TEDH from 2005 to 2012 were retrospectively reviewed, factors affecting the initial neurological status and outcomes were explored using univariate and multivariate analysis. RESULTS: There were 166 boys and 103 girls (average age: 7...

BACKGROUND: Cranial magnetic resonance imaging (MRI) was performed in 250 patients who had been unconscious post-trauma for at least 24 hours. The frequency and the characteristics of injuries to the upper cervical myelon were determined. PATIENTS AND METHODS: Between 1996 and 2009, MRI was carried out within 8 days of trauma. RESULTS: No lesions of the upper cervical medulla were found without accompanying damage to the medulla oblongata...

OBJECTIVE: We evaluated proton magnetic resonance spectroscopic imaging (MRSI) findings for children with traumatic brain injury attributable to nonaccidental trauma (NAT) early after injury, to determine whether brain metabolite changes predicted outcomes. METHODS: Proton MRSI (1.5 T) was performed (mean: 5 days after injury [range: 1-30 days]) through the level of the corpus callosum for 90 children with confirmed NAT. Regional N-acetylaspartate/total creatine, N-acetylaspartate/total choline, and choline/creatine ratios and the presence of lactate were measured...

PURPOSE: To describe the clinical and electroencephalographic features of three patients diagnosed with Panayiotopoulos syndrome with different lesions identified by cranial MRI investigation. METHODS: Our study was based on patients from the Epilepsy Outpatient Clinic of Sişli Etfal Education Hospital in Istanbul, where a prospective study of Panayiotopoulos syndrome was initiated in 1995. Records of our Epilepsy Outpatient Clinic revealed 53 patients with Panayiotopoulos syndrome...

OBJECTIVE: There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. METHODS: A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort...

The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age ( n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound ( n=4), computed tomography (CT) ( n=1) and post-mortem magnetic resonance imaging (MRI) ( n=1). Pathology findings were correlated with the imaging findings ( n=3)...

Our aim was to relate MRI findings in patients with severe traumatic brain injury (TBI) to clinical severity and long-term outcome. We studied 37 patients with severe TBI, who were submitted to clinical assessment for disability and cognition and to MRI 60-90 days after trauma. Clinical assessment was also performed 3, 6 and 12 months later. The number and volume of lesions in various cerebral structures were calculated semiautomatically from FLAIR and fast field-echo images. Possible correlations between total and regional lesion volume and clinical deficits were then investigated...

Cerebrospinal fluid (CSF) leakage may cause immediate or delayed complications, such as ascending meningitis and brain abscess, potentially lethal complications that may appear years or decades after the trauma. Thus, the initial treatment of a CSF fistula may decisively influence long-term outcome. In a retrospective study including 1036 consecutive patients presenting with severe cranial trauma from May 1990 to March 1996, we identified 27 patients (2.6%) with CSF fistulas. Patients with a post-traumatic CSF leak were most commonly males between 15 and 40 years involved in a motor vehicle accident...

We report the case of a traumatic Foix-Chavany-Marie syndrome (SFMC) which is the cortico-subcortical type of suprabulbar palsy. A 10-year-old boy was brain injured in a traffic accident in August 1996. He was found comatous (initial GCS = 6) without any focal neurological deficit. The hemodynamic situation was stable even though he presented two wounds of the scalp and a hemoperitoneum that required intensive perfusions. The initial CT scan elicited a frontal fracture, ischemo hemorrhagic lesions of the right frontopolar and anterior temporal cortex...

OBJECTIVES: The goal of our study was to identify clinical, neurophysiological and neuroradiological variables in severe head trauma (SHT) with predictive value for posttraumatic epilepsy (PTE) and to evaluate the influence of each risk factor for the dynamics of epilepsy. MATERIALS AND METHODS: We systematically compared 57 PTE patients with 50 age and sex-matched control patients with SHT and no PTE. Mean follow-up was 8 years. RESULTS: Of all PTE-patients 68...

We conducted a retrospective study to investigate the treatment and outcome of head injuries in children and adolescents in Taiwan. The study group consisted of 820 children and adolescents with head injuries admitted to Chang Gung Memorial Hospital from January 1985 to December 1989. The data were obtained from chart review and questionnaire. The cases were divided into four age-groups: group A (0-4 years old), group B (5-9 years old), group C (10-14 years old) and group D (15-17 years old). Computed tomogram of the brain was performed in 92% of the cases and most had abnormal findings...

Sixty-two children with traumatic extradural haematomas are considered According to the clinical history presented--often atypical--and to the grade of neurological impairment, patients have been divided into different clinical groups. Nearly 50% of patients sustained a minor injury, and 26% did not lose consciousness after trauma. Twenty-four per cent of patients did not show fractures on skull X-rays. Atypical location of the haematoma was noted in 22 cases, mainly in the anterior fossa (19 cases). Sixty patients were operated on, while two patients were conservatively treated, owing to the limited size of the haematomas and to the absence of neurological deficits...

56 traumatic intracerebral haemorrhages were surgically treated within a period of 3 years. In most cases, they were dur to severe craniocerebral traumas, often (in 71,4% of the patients) combined with calvarial fractures. The average age was 44,7 years, and the sex distribution male : female = 4:1. The temporal and frontal regions were the preferential sites in approximately equal incidence. Depending sites in approximately equal incidence. Depending upon the rapidity of the clinical course, acute haematomas are different from the sub-acute ones (12-hours limit); both groups differ from each other especially with regard to the prognosis involved...

Our experiences in 55 patients suffering from orbitofrontal injuries are discussed. The prognosis is determined by the severity of the brain injuries and the cerebral complications. The relation of fronto-basal, orbital, and maxillofacial fractures to lesions of the brain tissue and contents of the orbita is best demonstrated in high-resolution CT scan. Surgery is usually possible in one interdisciplinary operating session. Penetrating injuries with CSF leakage primarily require operative therapy; indirect, open, frontobasal fractures should be covered secondarily within two weeks following trauma...

There is increasing evidence from human and experimental studies that the most important factor governing the outcome in head injury is the severity of diffuse axonal injuries. The authors have experienced 18 cases of severe diffuse axonal injury which showed post-traumatic coma for more than 24 hours and CT findings resembling those of shearing injuries of the cerebral white matter such as have been presented by Zimmerman et al. (1978). The consciousness levels on admission were 6 or less on the Glasgow Coma Scale and all cases were shown clinically to have primary brain stem injury...

Traumatic intraventricular haemorrhage (TVH) is rare. The clinical profile and prognosis in 16 patients with traumatic intraventricular haemorrhage after blunt head injury are evaluated. Majority of the patients (94%) had low Glasgow coma score (less than 8) on admission and none had a lucid interval. CT showed haematoma adjacent to the foramen of Monroe in 5 patients and localised to the frontal horn or the body of the lateral ventricle in six. The mortality was 62.5% in this subgroup of patients with head injury...