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Recovery As Distinguished From Development Recovery As Distinguished From Development
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Perceptual Abilities Perceptual Abilities
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Motor Deficits Motor Deficits
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Memory Memory
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Attention and Working Memory Attention and Working Memory
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Communication and Language Communication and Language
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Executive Function Executive Function
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Academic Achievement and Intelligence Academic Achievement and Intelligence
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Moderator Variables And Pre-Injury Factors Moderator Variables And Pre-Injury Factors
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Psychiatric Disorders Psychiatric Disorders
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Methodology Methodology
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Pre-injury Psychiatric Disorder Pre-injury Psychiatric Disorder
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New-onset Psychiatric Disorder New-onset Psychiatric Disorder
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Personality Change Due to Traumatic Brain Injury Personality Change Due to Traumatic Brain Injury
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Secondary Attention-deficit Hyperactivity Disorder Secondary Attention-deficit Hyperactivity Disorder
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Oppositional Defiant Disorder Oppositional Defiant Disorder
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Posttraumatic Stress Disorder Posttraumatic Stress Disorder
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Obsessive Compulsive Disorder Obsessive Compulsive Disorder
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Other Anxiety Disorders Other Anxiety Disorders
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Mania and Hypomania Mania and Hypomania
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Depressive Disorders Depressive Disorders
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Psychosis Psychosis
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Treatment Treatment
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Treatment for Cognitive and Academic Problems Treatment for Cognitive and Academic Problems
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Treatment for Psychiatric/Behavioral Problems Treatment for Psychiatric/Behavioral Problems
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Conclusion Conclusion
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References References
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64753 Neuropsychological and Psychiatric Outcomes of Traumatic Brain Injury in Children
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Published:April 2010
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Abstract
Pediatric traumatic brain injury (TBI) is a major health concern, with an annual incidence of 400 in 100,000 and it is the major cause of disability and death in children in the United States (Langlois, Rutland-Brown, and Thomas 2005). The Glasgow Coma Scale (GCS) (Teasdale and Jennett 1974) is a standard measure of severity of impaired consciousness, and it is used as a measure of TBI severity. Mild TBI is generally defined by the lowest post-resuscitation GCS score of 13–15, but many investigators have also stipulated that a mild TBI is defined by a normal computed tomographic (CT) scan within 24 hours after injury or at least no CT evidence of a brain lesion. Moderate injury has a GCS score of 9–12 or a score of 13–15 with an intracranial lesion. Severe injury has a GCS score of 8 or lower, consistent with coma. The pathology of TBI can be classified into diffuse and focal brain injury, although both types of injury can coexist in the same patient. Focal brain injury is characterized by mechanical forces that produce localized primary lesions that occur at the moment of trauma, such as cortical contusions. In closed head injuries, these forces can also produce hemorrhage in the epidural, subdural, subarachnoid, or intracerebral compartments of the cranium. Diffuse brain injury, more common in children than in adults with severe TBI, is caused by rapid movement of the head due to acceleration, deceleration, and rotational forces, which causes primary axonal injury, such as axonal stretch and shearing. Occurring immediately after trauma and producing effects that may progress over time, secondary injuries include ischemia, brain swelling, breakdown of the blood- brain barrier, release of excitatory neurotransmitters, generation of free radicals, cellular death and dysfunction, hypoxemia, and seizures. Hypotension is a serious complication of TBI and a challenge for acute neurocritical care (Kochanek 2006).
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