Delayed Recovery of Intellectual Function After Minor Head Injury

Gronwall, Dorothy; Wrightson, Philip

doi:10.1016/s0140-6736(74)91939-4

Cited by 479 publications

(189 citation statements)

References 2 publications

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“…Retrograde and anterograde amnesia have been well documented after TBI in humans [30,52,61]. In the laboratory, the Morris water maze (MWM) and radial arm maze routinely demonstrate injury-related cognitive deficits [37,54,63,67].…”

Section: Discussionmentioning

confidence: 99%

Acute cognitive impairment after lateral fluid percussion brain injury recovers by 1 month: Evaluation by conditioned fear response

Lifshitz

Witgen

Grady

2007

Behavioural Brain Research

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Conditioned fear associates a contextual environment and cue stimulus to a foot shock in a single training trial, where fear expressed to the trained context or cue indicates cognitive performance. Lesion, aspiration or inactivation of the hippocampus and amygdala impair conditioned fear to the trained context and cue, respectively. Moreover, only bilateral experimental manipulations, in contrast to unilateral, abolish cognitive performance.In a model of unilateral brain injury, we sought to test whether a single lateral fluid percussion brain injury impairs cognitive performance in conditioned fear. Brain-injured mice were evaluated for anterograde cognitive deficits, with the hypothesis that acute injury-induced impairments improve over time. Male C57BL/6J mice were brain-injured, trained at five or 27 days post-injury, and tested 48 hours later for recall of the association between the conditioned stimuli (trained context or cue) and the unconditioned stimulus (foot shock) by quantifying fear-associated freezing behavior. A significant anterograde hippocampal-dependent cognitive deficit was observed at seven days in brain-injured compared to sham. Cued fear conditioning could not detect amygdala-dependent cognitive deficits after injury and stereological estimation of amygdala neuron number corroborated this finding. The absence of injury-related freezing in a novel context substantiated injury-induced hippocampal-dependent cognitive dysfunction, rather than generalized fear. Variations in the training and testing paradigms demonstrated a cognitive deficit in consolidation, rather than acquisition or recall. By one month post-injury, cognitive function recovered in brain-injured mice. Hence, the acute injury-induced cognitive impairment may persist while transient pathophysiological sequelae are underway, and improve as global dysfunction subsides.

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Section: Discussionmentioning

confidence: 99%

Acute cognitive impairment after lateral fluid percussion brain injury recovers by 1 month: Evaluation by conditioned fear response

Lifshitz

Witgen

Grady

2007

Behavioural Brain Research

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“…There is general agreement in the literature that severe head injuries are associated with significant disabilities in both children and adults. The adult literature has described disabilities after minor head injury [23][24][25] ; however, conflicting reports exist concerning disability after mild head injury in children. The report by Di Scala et al 6 on children with a wide spectrum of injury severity revealed impairments of daily living functions, cognition, and behavior in children with minor head injury.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Testing for Acute Head Injury in Children: When Are Head Computed Tomography and Skull Radiographs Indicated?

et al. 1997

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ABSTRACT. Objective. Despite the frequent occurrence of head injury in children, there is no agreement about clinical screening criteria that indicate the need for imaging studies. This study was undertaken to provide information relevant to the choice of imaging modalities in children with acute head trauma.Methodology. A prospective cohort of 322 children seeking care consecutively in an urban pediatric emergency department for nontrivial head injury was assembled. Skull radiographs, head computed tomography, and data forms including mechanism of injury, symptoms, and physical findings were completed for each child.Results. Intracranial injury occurred in 27 children (8%), whereas 50 (16%) had skull fractures. Of those with intracranial injury, 16 (59%) had normal mental status and no focal abnormalities, and 1 of those 16 required surgery for evacuation of an epidural hematoma. Six (38%) of the 16 were younger than 1 year, 5 of whom had scalp contusion or hematoma without other symptoms. Findings not significantly associated with intracranial injury were scalp contusion, laceration, hematoma, abrasion, headache, vomiting, seizure, drowsiness, amnesia, and loss of consciousness for less than 5 minutes. Findings associated with intracranial injury were skull fracture, signs of a basilar skull fracture, loss of consciousness for more than 5 minutes, altered mental status, and focal neurologic abnormality.Conclusions. Intracranial injury may occur with few or subtle signs and symptoms, especially in infants younger than 1 year. The relative risk for intracranial injury is increased almost fourfold in the presence of a skull fracture, although the absence of a skull fracture does not rule out intracranial injury. The significance of nonsurgical intracranial injury in neurologically normal children needs further study. Pediatrics 1997;99(5). URL: http://www.pediatrics.org/cgi/content/full/99/5/e11; brain injuries, head injuries, skull fractures, computed tomography, radiography.

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“…9) The Paced Auditory Serial Attention Test, 2-s interstimulus interval version (Gronwall & Wrightson, 1974 ).…”

Section: Measures Of Attentionmentioning

confidence: 99%

Do sleep difficulties exacerbate deficits in sustained attention following traumatic brain injury?

Bloomfield

Espie

Evans

2009

J Int Neuropsychol Soc

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Sustained attention has been shown to be vulnerable following traumatic brain injury (TBI). Sleep restriction and disturbances have been shown to negatively affect sustained attention. Sleep disorders are common but under-diagnosed after TBI. Thus, it seems possible that sleep disturbances may exacerbate neuropsychological defi cits for a proportion of individuals who have sustained a TBI. The aim of this prospective study was to examine whether poor sleepers post-TBI had poorer sustained and general attentional functioning than good sleepers post-TBI. Retrospective subjective, prospective subjective, and objective measures were used to assess participants' sleep. The results showed that the poor sleep group had signifi cantly poorer sustained attention ability than the good sleep group. The differences on other measures of attention were not signifi cant. This study supports the use of measures that capture specifi c components of attention rather than global measures of attention, and highlights the importance of assessing and treating sleep problems in brain injury rehabilitation. ( JINS , 2010, 16, 17-25.)

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Delayed Recovery of Intellectual Function After Minor Head Injury

Cited by 479 publications

References 2 publications

Acute cognitive impairment after lateral fluid percussion brain injury recovers by 1 month: Evaluation by conditioned fear response

Acute cognitive impairment after lateral fluid percussion brain injury recovers by 1 month: Evaluation by conditioned fear response

Diagnostic Testing for Acute Head Injury in Children: When Are Head Computed Tomography and Skull Radiographs Indicated?

Do sleep difficulties exacerbate deficits in sustained attention following traumatic brain injury?

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