The occurrence of personality change due to traumatic
brain injury (PC), and its clinical and neuroimaging correlates
were investigated. Ninety-four children, ages 5 through
14 at the time of hospitalization following traumatic brain
injury (TBI; severe TBI N = 37;
mild–moderate TBI N = 57),
were assessed. Standardized psychiatric, adaptive functioning,
cognitive functioning, family functioning, family psychiatric
history, severity of injury, and neuroimaging assessments
were conducted. The Neuropsychiatric Rating Schedule (NPRS)
was used to establish a diagnosis of PC. Approximately 40%
of consecutively hospitalized severe TBI participants had
ongoing persistent PC an average of 2 years postinjury.
An additional approximately 20% had a history of a remitted
and more transient PC. PC occurred in 5% of mild–moderate
TBI but was always transient. Interrater reliability for the
diagnosis of PC was good (Kappa = .70). In severe TBI
participants, persistent PC was significantly associated
with severity of injury, particularly impaired consciousness
over 100 hr, adaptive and intellectual functioning decrements,
and concurrent diagnosis of secondary attention deficit
hyperactivity disorder, but was not significantly related to
any psychosocial adversity variables. These findings suggest
that PC is a frequent diagnosis following severe TBI in
children and adolescents, but is much less common following
mild–moderate TBI. (JINS, 2000, 6,
279–289.)
Shprintzen-Goldberg syndrome is one of a group of disorders characterized by craniosynostosis and marfanoid habitus. Eleven cases were reported previously. We present 4 new patients and review one of the patients of the original report of Shprintzen and Goldberg [1982: J Craniofac Genet Dev Biol 2:65-74], 15 years later. The clinical and radiologic findings on our patients are compared with those of the previously reported patients and also with those of Furlong et al. [1987: Am J Med Genet 26:599-604] and Lacombe and Battin [1993: Clin Dysmorphol 2: 220-224], who share many of the characteristics of Shprintzen-Goldberg syndrome. Some of the clinical data are helpful in determining if the patients of Furlong et al. [1987: Am J Med Genet 26:599-604] and Lacombe and Battin [1993: Clin Dysmorphol 2: 220-224] have a separate syndrome or represent a variant of Shprintzen-Goldberg syndrome. However, radiologic investigations appear to be more specific, since an abnormality of the first and second cervical vertebrae, hydrocephalus, dilatation of the lateral ventricles, and a Chiari-I malformation of the brain were found only in the patients with Shprintzen-Goldberg syndrome. The apparently diagnostic findings of the 15 patients with this syndrome may be helpful in differentiating between Shprintzen-Goldberg syndrome and other syndromes with craniosynostosis and marfanoid habitus.
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