Article

The variety and extent of impairments occurring after traumatic brain
injury vary according to the nature and severity of the lesions. In order to
better understand their interactions and long-term outcome, we have studied and
compared the cognitive and neurobehavioral profile one year post onset of
patients with and without traumatic brain injury in a cohort of motor vehicle
accident victims. METHOD: The study population is composed of 207 seriously
injured persons from the ESPARR cohort. This cohort, which has been followed up
in time, consists in 1168 motor vehicle accident victims (aged 16 years or more)
with injuries with all degrees of severity. Inclusion criteria were: living in
Rhone county, victim of a traffic accident having involved at least one
wheel-conducted vehicle and having occurred in Rhone county, alive at the time of
arrival in hospital and having presented in one of the different ER facilities of
the county. The cohort's representativeness regarding social and geographic
criteria and the specificities of the accidents were ensured by the specific
targeting of recruitment. Deficits and impairments were assessed one year after
the accident using the Neurobehavioral Rating Scale - Revised and the
Trail-Making Test. Within our seriously injured group, based on the Glasgow
Score, the presence of neurological deficits, aggravation of neurological
condition in the first 72hours and/or abnormal cerebral imaging, we identified
three categories: (i) moderate/severe traumatic brain injury (n=48), (ii) mild
traumatic brain injury (n=89), and (iii) severely injured but without traumatic
brain injury (n=70). RESULTS: The most frequently observed symptoms were anxiety,
irritability, memory and attention impairments, depressive mood and emotional
lability. While depressive mood and irritability were observed with similar
frequency in all three groups, memory and attention impairments, anxiety and
reduced initiative were more specific to traumatic brain injury whereas executive
disorders were associated with moderate/severe traumatic brain injury.
CONCLUSION: The presence and the initial severity of a traumatic brain
injury condition the nature and frequency of residual effects after one year.
Some impairments such as irritability, which is generally associated with
traumatic brain injury, do not appear to be specific to this population, nor does
depressive mood. Substantial interactions between cognitive, affective and
neurobehavioral disorders have been highlighted.
CI - Copyright (c) 2014 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS ; FRANCAIS