Publicação
Traumatismo Crânio-Encefálico – Impacto no neurodesenvolvimento
| Resumo: | Introduction: Traumatic brain injury (TBI) represents, worldwide, one of the main causes of morbidity and mortality at pediatric age and can have consequences in neurodevelopment, either immediate or later on time. These changes across several domains have a very heterogeneous installation and expression. Objectives: To describe the predictors of outcome in neurodevelopment associated with TBI; to analyze their relationship with the impact across different domains of the neurodevelopment; to mention potential rehabilitations and to propose a follow up protocol based on the most relevant literature findings.Methods: Bibliographic research over electronical databases, on health sciences, namely PubMed, ClinicalKey and ScienceDirect with the inclusion of articles both in English and in Portuguese published between 1994 and 2019.Results: Diffuse traumatic lesion, severe lesions (Pediatric Glasgow Coma Scale score of 8 or less) and younger age at injury were identified as predictors of negative outcome in these children/adolescents’ neurodevelopment. Family and social environment, in which the child/adolescent is set, influences the functional recovery as well as the stress and the physical/emotional burden arising with the chronicity of the sequelae. Neurodevelopment level and skills set previous to the lesion, or it’s deficits, not only act as risk factors to the happening of the TBI but also are predictors of outcome, with pre TBI deficits associated with more sequelae, being these more notorious over emerging and developing skills at the moment of the insult. Neurodevelopment areas more frequently affected are language/communication, cognition, executive functions and behavior/social competence, with differences in the severity of their affection, as well as on the time of recovery. Rehabilitation tries to promote this children/adolescents’ reintegration and their recovery on the areas with greater difficulties. Conclusion: The occurrence of a TBI at pediatric age can bring important consequences on neurodevelopment and quality of life. The outcome both immediately and later on time will depend on several factors, that when analyzed together can point the domains that will more likely present deficits. From this factors’ interaction, some inherent to the child (age, pre-injury skills and neurodevelopment stage) and others external (lesion characteristics and family setting), results a heterogenous set, with it’s understanding essential to the establishment of follow-up strategies that fill both observed and foreseen needs. |
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| Autores principais: | Sequeira, Miguel dos Santos |
| Assunto: | Traumatismo crânio-encefálico infância neurodesenvolvimento preditores de prognóstico reabilitação Traumatic brain injury childhood neurodevelopment predictors of outcome rehabilitation |
| Ano: | 2020 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso embargado |
| Instituição associada: | Universidade de Coimbra |
| Idioma: | português |
| Origem: | Estudo Geral - Universidade de Coimbra |
| Resumo: | Introduction: Traumatic brain injury (TBI) represents, worldwide, one of the main causes of morbidity and mortality at pediatric age and can have consequences in neurodevelopment, either immediate or later on time. These changes across several domains have a very heterogeneous installation and expression. Objectives: To describe the predictors of outcome in neurodevelopment associated with TBI; to analyze their relationship with the impact across different domains of the neurodevelopment; to mention potential rehabilitations and to propose a follow up protocol based on the most relevant literature findings.Methods: Bibliographic research over electronical databases, on health sciences, namely PubMed, ClinicalKey and ScienceDirect with the inclusion of articles both in English and in Portuguese published between 1994 and 2019.Results: Diffuse traumatic lesion, severe lesions (Pediatric Glasgow Coma Scale score of 8 or less) and younger age at injury were identified as predictors of negative outcome in these children/adolescents’ neurodevelopment. Family and social environment, in which the child/adolescent is set, influences the functional recovery as well as the stress and the physical/emotional burden arising with the chronicity of the sequelae. Neurodevelopment level and skills set previous to the lesion, or it’s deficits, not only act as risk factors to the happening of the TBI but also are predictors of outcome, with pre TBI deficits associated with more sequelae, being these more notorious over emerging and developing skills at the moment of the insult. Neurodevelopment areas more frequently affected are language/communication, cognition, executive functions and behavior/social competence, with differences in the severity of their affection, as well as on the time of recovery. Rehabilitation tries to promote this children/adolescents’ reintegration and their recovery on the areas with greater difficulties. Conclusion: The occurrence of a TBI at pediatric age can bring important consequences on neurodevelopment and quality of life. The outcome both immediately and later on time will depend on several factors, that when analyzed together can point the domains that will more likely present deficits. From this factors’ interaction, some inherent to the child (age, pre-injury skills and neurodevelopment stage) and others external (lesion characteristics and family setting), results a heterogenous set, with it’s understanding essential to the establishment of follow-up strategies that fill both observed and foreseen needs. |
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