Cognition in relation to magnetic resonance imaging in head-injured children and adolescents

H. S. Levin, K. A. Culhane, D. Mendelsohn, M. A. Lilly, D. Bruce, J. M. Fletcher, S. B. Chapman, H. Harward and H. M. Eisenberg
Division of Neurosurgery, University of Texas Medical Branch, Galveston.

To investigate the relationship between cognitive sequelae and magnetic resonance imaging (MRI) findings following closed head injury of varying severity in the pediatric age range, 76 head-injured children and adolescents were studied at least 3 months after trauma and compared with 57 normal controls. Problem solving, planning, verbal and design fluency, memory, and response modulation were assessed. Significant effects of injury were obtained on all of the cognitive measures. Cognitive impairment was more consistently present on the various outcome measures in children who were 6 to 10 years old at the time of the study than in the older children and adolescents. Magnetic resonance imaging disclosed areas of abnormal signal in the frontal lobes of 42 patients, whereas focal lesions restricted to the extrafrontal region were found in 15 children. Regression analyses disclosed that taking into account the size of frontal lobe lesion enhanced the relationship between cognitive performance and the severity of injury.

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