Fufaeva E V, Mikadze Yu V, Lukyanov V I
Clinical and Research Institute of Urgent Pediatric Surgery and Traumatology, Moscow, Russia.
Lomonosov Moscow State University, Moscow, Russia; Pirogov Russian National Research Medical University, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2017;117(11. Vyp. 2):33-40. doi: 10.17116/jnevro201711711233-40.
To follow up patterns of cognitive recovery in children (6-17 years of age) at the first four months after a severe traumatic brain injury (TBI).
Seventeen children with TBI (GCS ≤8) were evaluated with the Coma Recovery Scale-R (CRS). Children were stratified into three groups according to their consciousness recovery. Seven children regained their consciousness completely and were assessed by the Luria Neuropsychological Battery test. Six children remained in the minimally conscious state (MCS) and were tested by the adapted procedure of neuropsychological assessment during the first four months. Four children with low level of consciousness were evaluated with CRS.
The most destroying functions at the early recovery period were the processing speed (neurodynamics of mental activity), executive functions and memory. Children with the anterior cortex damage had the slowest dynamics of recovery. The slower dynamics of consciousness recovery was combined with severe primary damages of visual gnosis, speech and executive functions according to neuropsychological examination. The positive dynamics of consciousness recovery was combined with early behavioral changes and the greater rate of behavioral changes.
追踪重度创伤性脑损伤（TBI）后前四个月儿童（6 - 17岁）认知恢复模式。
17名TBI儿童（格拉斯哥昏迷量表评分≤8）接受昏迷恢复量表修订版（CRS）评估。根据意识恢复情况将儿童分为三组。7名儿童完全恢复意识，并通过鲁利亚神经心理成套测验进行评估。6名儿童处于最低意识状态（MCS），并在头四个月通过神经心理评估的改编程序进行测试。4名意识水平较低的儿童用CRS进行评估。
恢复早期受影响最严重的功能是处理速度（心理活动的神经动力学）、执行功能和记忆。额叶皮质受损的儿童恢复动态最慢。根据神经心理学检查，意识恢复动态较慢与视觉认知、言语和执行功能的严重原发性损伤相关。意识恢复的积极动态与早期行为变化及更大的行为变化速率相关。
