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  Cognitive sequelae of diffuse axonal injury

Scheid, R., Walther, K., Guthke, T., Preul, C., & von Cramon, D. Y. (2006). Cognitive sequelae of diffuse axonal injury. Archives of Neurology, 63(3), 418-424. doi:10.1001/archneur.63.3.418.

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Item Permalink: http://hdl.handle.net/11858/00-001M-0000-0010-A496-E Version Permalink: http://hdl.handle.net/11858/00-001M-0000-002C-7C2F-0
Genre: Journal Article

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 Creators:
Scheid, Rainer1, Author              
Walther, Katrin, Author
Guthke, Thomas2, Author              
Preul, Christoph1, Author              
von Cramon, D. Yves1, Author              
Affiliations:
1Department Cognitive Neurology, MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_634563              
2External Organizations, ou_persistent22              

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 Abstract: BACKGROUND: The results of recent studies on cognitive disability after traumatic brain injury-associated diffuse axonal injury (DAI) are inconsistent. In these studies, the diagnosis of DAI relied on cranial computed tomography. OBJECTIVE: To further clarify the extent and severity of a possibly DAI-associated cognitive impairment by the use of magnetic resonance imaging (MRI) and detailed neuropsychological testing. DESIGN AND PARTICIPANTS: From a databank of 299 patients with traumatic brain injury, 18 patients (age range, 17-50 years; median initial Glasgow Coma Scale score, 5) who showed an MRI lesion pattern compatible with pure DAI were identified. All of the patients had undergone MRI on a 3-T system. Pure DAI was defined by the findings of traumatic microbleeds on T2*-weighted gradient-echo images in the absence of otherwise traumatic or nontraumatic MRI abnormalities. MAIN OUTCOME MEASURES: Neuropsychological performance in the categories of attention and psychomotor speed, executive functions, spans, learning and memory, and intelligence 4 to 55 months (median, 9 months) after traumatic brain injury. RESULTS: All of the patients showed impairments of 1 or more cognitive subfunctions, and no cognitive domain was fundamentally spared. Memory and executive dysfunctions were most frequent, the former reaching a moderate to severe degree in half of the patients. In comparison, deficits of attention, executive functions, and short-term memory were mostly mild. Correlations between the amount of traumatic microbleeds and specific or global cognitive performance were absent. CONCLUSIONS: An MRI lesion pattern compatible with isolated DAI is associated with persistent cognitive impairment. The traumatic microbleed load is no sufficient parameter for the assessment of DAI severity or functional outcome.

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Language(s): eng - English
 Dates: 2006
 Publication Status: Published in print
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 Identifiers: eDoc: 285232
Other: P7183
DOI: 10.1001/archneur.63.3.418
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Title: Archives of Neurology
Source Genre: Journal
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Publ. Info: Chicago, IL : American Medical Association
Pages: - Volume / Issue: 63 (3) Sequence Number: - Start / End Page: 418 - 424 Identifier: ISSN: 0003-9942
CoNE: https://pure.mpg.de/cone/journals/resource/954922843241