Neurocognitive disorders in patients with severe traumatic brain injury (TBI)
Abstract
Objectives: to describe neurogcognitive disorders present in patients with severe TBI and the outcome at dischargeMethod: to assess patients at admission and discharge with the following neurocognitive tests: WAIS; Mini Mental; direct and inverse Digit; Letter Cancelation Test; Stroop Test; Trail Making B. manual sequence test; alternative sequences test. Wais
Comprehension Test; Rey´s Complex Figure Analogy Test; Rey Auditory Verbal Learning Test; Wais Arithmetic Sub Test; Inverse repetition of Digits; Wais Digits- Symbols; Boston Nomination Test; Verbal Fluency; Wais vocabulary Sub Test; London Tower for Procedural Memory and Rey´s Complex; Figure and The Clock Test.
Outcome: 28 patients joined cognitive rehabilitation. 35% patients had high school education and 65% elementary school education. Attention, memory and executive function areas of the brain were affected in 100% of the patients. At discharge, regarding patients with elementary education, 33% continued with attention disorders, 22%with memory disorders and 94% with executive function disorders, whereas taking into account patients with high school education only 10% continued with attention and memory disorders and 60% with executive function
disorders. 66% of the patients with elementary education and 60% with high school education had language impairments , at discharge this percentage was reduced to 16% and 10% respectively. 66% of patients with elementary education and 80% of patients with high school education presented Logical Reasoning disorders; at discharge, 55% of the patients with elementary education continued with the same disorder and in the case of patients with high school education only 10% continued with this disorder. Praxia and gnosis were affected 20% in both groups. At discharge, 5% of patients with elementary education continued with the same disorder, but they disappeared on the patients with high school education.
Discussion: cognitive disorders are very common sequela in TBI. These sequel a can lead to long term disabilities and loss of productivity which can, sometimes, be more invalidating than any physical limitation. Since most of the patients that undergo TBI are young and active work wise , the economic cost,the time lost from work and the impact on the patient ´s life quality and his family is huge. Therefore, it is important to have measurements of results in TBi survivors to provide a guide to the patient, family and caregivers about the possibilities of recuperation.
References
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32. Gonzalez, M.; Pueyo, R y Serra, J. Secuelas neuropsicológicas de los traumatismos craneoencefálicos. Anales de Psicología, 2004;20(2):303-316.
33. Mataró, M., Pueyo, R. y Jurado, M. Rehabilitación en la atención. Avances en Psicología Clínica Latinoamericana, 2003;21: 31-38.
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35. Roig, J., Roig, T. y Enseñat, A. (2000). Evaluaciónde la atención y velocidad de procesamiento de la información en TCE con versión computarizada del STROOP. Recuperado el 13 de octubre, 2008 de http://www.uninet. edu/union99/congress.
36. Chan, R. Sustained attention in patients with mild traumatic brain injury. Clinical Rehabilitation, 2005;19,188-193.
37. Godefroy, O. y Rousseaux, M. Divided and focused attention in patients with lesion of the prefrontal cortex. Brain and Cognition, 1996;30:155-174.
38. Keil, K y Kaszniak, A.W. Examining executive function in individuals with brain injury. A review. Aphasiology, 2002; 16: 305-335.
39. Caraciel A .y Cuberos, G. Los Traumatismos Craneoencefálicos. En M. Pérez (ed). Manual de Neuropsicología Clínica. Madrid: Pirámide, 2009; pp.143-158.
40. Kerr, C. Dysnomia following traumatic brain injury: an information-processing approach to assessment. Brain Injury, 1995;9: 777-796.
41. Lezak, M; Howieson, D y Loring, D. Neuropsychological Assessment, 4 ed, Nueva York, Oxford University Press, 2004.
2. Arango Lasprilla, J.C. Rehabilitación Neuropsicológica, 2006; pp. 117-139.
3. Bigler, E. D. Brain imaging and behavioral outcome in traumatic brain injury. Journal of Learning Disabilities, 1996;29:515-530.
4. Burin,D; Drake,M. y Harris,P. Evaluación Neuropsicológica en Adultos. Paidos, 2007.
5. Junqué, C., Bruna, O. y Mataró, M. Traumatismos craneoencefálicos. Un enfoque desde la neuropsicologia y la logopedia. Barcelona: Masson, 1998.
6. Almi C.R. y Finger S. Brain injury and recovery of function: theories and mechanism of functional reorganization. Journal of Head Trauma and Rehabilitation, 1992;7:70-77.
7. González Ariza M., Roser Pueyo B. y Serra Grabulosa J.M. Secuelas neuropsicológicas de los traumatismos craneoencefálicos. Anales de psicología 2004;20(2):303-316.
8. Levin, H. S., Gary, H. E., Jr., Eisenberg, H. M., Ruff, R.M., Barth, J. T., Kreutzer, J., High, W. M., Jr., Portman,S., Foulkes, M. A., Jane, J. A., Marmarou, A. yMarshall, L.F. Neurobehavioral outcome 1 year after severe head injury. Experience of the Traumatic Coma Data Bank. Journal of Neurosurgery, 1990b; 73:699-709.
9. Wilson, B., Vizor, A. y Bryant, T. Predicting severity of cognitive impairment after severe head injury. Brain Injury, 1991;5:189-197.
10. Ladera Fernández V. Síndrome amnésico postraumático. Rev Neuro 2001;32(5):467-73.
11. Uzzell, B. P., Obrist, W. D., Dolinskas, C. A. y Langfitt, T.W. Relationship of acute CBF and ICP findings to neuropsychological outcome in severe head injury. Journal of Neurosurgery, 1986;65:630-635.
12. Ariza, M., Mataró, M., Poca, M.A., Junqué, C., Garnacho,A., Amorós, S. y Sahuquillo, J. Influence of extraneurological insults on ventricular enlargement and neuropsychological functioning after moderate and severe traumatic brain injury. Journal of Neurotrauma (en prensa).
13. Bigler, E. D. The lesion in traumatic brain injury:implications for clinical neuropsychology. Archives of Clinical Neuropsychology, 2001;16:95-131.
14. Junqué C. Secuelas neuropsicológicas de los trauma craneoencefálico. Rev Neurol 1999; 28(4):423-430.
15. Muñoz Céspedes J.M., Pelegrín Valero C., Tirapu Ustarroz J., Fernández Guinea S. Sobre la naturaleza, diagnóstico y tratamiento del síndrome posconmocional. Rev Neurol 1998;27(159):844-853.
16. Burin D.I., Drake, M., Harris, P. Evaluación Neuropsicológica en Adultos. Editorial Paidos.1era edición.2007.
17. Lezak, M.; Neuropsychological Assessment, 3 ed, Nueva York, Oxford University Press. 1995.
18. WAIS-III. Test de Inteligencia para Adultos, Buenos Aires. Ed. Paidos, 2002.
19. Folstein, M.F; Folstein.S.E. y McHugh, P.R. Mini Mental State. A practical method for grading the cognitive state of patients for the clinician, J Psychiatr Res, nov., 1975;12(3):189-198.
20. Mesulam, M.M. Principles of Behavioural Neurology, Philadelphia: Davis Company, 1985.
21. Golden, C. Stroop Test de Colores y de Palabras, Madrid, TEA Ediciones, 1994.
22. Reitan, R. M. Validity of the trail making test as an indicator of organic brain damage. Perceptual and Motor Skills, 1958;8: 271-276.
23. Fernandez, A.L.; Marino, J, Alderete, A.M. Estandarización y Validez Conceptual del Test del Trazo en una muestra de adultos argentinos. Rev. Neurol. Arg., 2002;27:83-88.
24. Christensen. El diagnóstico neuropsicológico de Luria, Madrid: Visor, 1987.
25. Rey, A. Test de Copia de una Figura Compleja, Madrid, TEA, 1987.
26. Rey, A. L’examen clinique en psychologie. Paris: Presses Universitaires de France, 1964.
27. Kaplan, E., Goodglas, H. y Weintraub, S. Test de Vocabulario de Boston. Madrid: Editorial Médica Panamericana, 1986.
28. Culbertson, W.C. y Zillmer,E.A. Tower of London.Drexel University,Technical Manual, 2 Ed.,Toronto, Multi-Health System Inc. 2005.
29. Freedman, M; Leach, L;Kaplan, E; Winocur, G; Shulman, K.I y Delic, D.C. Clock Drawin: a Neuropsychological Analysis, Nueva York: Oxford University Press. 1994.
30. Gigena, V.M; Mangone,C.A; Baumann, D.et. al. El test del Reloj. Una evaluación cognitiva rápida y sensible al deterioro incipiente. Rev. Neurol. Arg. 1993;18:35-42.
31. Carrión José León. Rehabilitación Neuropsicológica del Daño Cerebral. Mente y Cerebro 45/2010; p. 62-71.
32. Gonzalez, M.; Pueyo, R y Serra, J. Secuelas neuropsicológicas de los traumatismos craneoencefálicos. Anales de Psicología, 2004;20(2):303-316.
33. Mataró, M., Pueyo, R. y Jurado, M. Rehabilitación en la atención. Avances en Psicología Clínica Latinoamericana, 2003;21: 31-38.
34. Van Zomeren, A. H. y Brouwer, W. H. Attentional deficits after closed head injury. En J. Crawford,W. McKinley y D. Parker (Eds.), Principles and practice of neuropsychological assessment. London: Taylor& Francis, 1990a.
35. Roig, J., Roig, T. y Enseñat, A. (2000). Evaluaciónde la atención y velocidad de procesamiento de la información en TCE con versión computarizada del STROOP. Recuperado el 13 de octubre, 2008 de http://www.uninet. edu/union99/congress.
36. Chan, R. Sustained attention in patients with mild traumatic brain injury. Clinical Rehabilitation, 2005;19,188-193.
37. Godefroy, O. y Rousseaux, M. Divided and focused attention in patients with lesion of the prefrontal cortex. Brain and Cognition, 1996;30:155-174.
38. Keil, K y Kaszniak, A.W. Examining executive function in individuals with brain injury. A review. Aphasiology, 2002; 16: 305-335.
39. Caraciel A .y Cuberos, G. Los Traumatismos Craneoencefálicos. En M. Pérez (ed). Manual de Neuropsicología Clínica. Madrid: Pirámide, 2009; pp.143-158.
40. Kerr, C. Dysnomia following traumatic brain injury: an information-processing approach to assessment. Brain Injury, 1995;9: 777-796.
41. Lezak, M; Howieson, D y Loring, D. Neuropsychological Assessment, 4 ed, Nueva York, Oxford University Press, 2004.
How to Cite
1.
Longoni M, Peralta S. Neurocognitive disorders in patients with severe traumatic brain injury (TBI). Rev. Colomb. Med. Fis. Rehabil. [Internet]. 2012 Apr. 14 [cited 2024 May 18];21(2):86-94. Available from: https://revistacmfr.org/index.php/rcmfr/article/view/11
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