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Kurihara M.,The Kanagawa Rehabilitation Center
Nippon rinsho. Japanese journal of clinical medicine | Year: 2010

Higher cortical dysfunction after traumatic brain injury(TBI) is one of the most important aspects for rehabilitation. Main etiology is traffic accidents and classification after TBI is diffuse axonal injury, cerebral contusion, etc. Though Wechsler Intelligence Scale for Children-III, Kaufman assessment battery for children, Trail Making Test, etc. are used for assessing higher cortical dysfunction in children, the most important evaluation method is to get information precisely from his/her families and teachers. Memory disturbance, attention deficit and dyscontrol of feeling are the top 3 symptoms of higher cortical dysfunction in children with TBI. Support for re-entrance to schools should be begun as fast as possible with cooperation among hospitals, schools and homes. As many problems are observed in the aspects of study, behavior, communication, etc, a lot of support from the professional staffs is necessary. After the school age, support should be continued by stuffs for adult cases. Source

Kurihara M.,The Kanagawa Rehabilitation Center
Nippon rinsho. Japanese journal of clinical medicine | Year: 2011

The prognosis in children with acute encephalopathy who were achieved rehabilitation in our rehabilitation center was presented. Main sequelae was motor disturbance 25%, mental deterioration 90%, higher cortical dysfunction 80% and epilepsy 70%. The patients were divided into 5 groups according to the clinical courses at the onset: cases with metabolic disorders, cases with cytokine storms, cases with status convultics, cases with severe refractory status epilepticus, and cases with the main symptom of decreased consciousness. Typical cases of each group were showed with their brain MRI and single photon emission cerebral tomography (SPECT). In cases with metabolic disorders and cytokine storms, the sequelae were generally severe. In cases with status convulticus, main sequelae was mental deterioration. In cases with severe refractory status epileptics, most contraversial problem was epilepsy. In cases with the main symptom of decreased consciousness, higher cortical dysfunction was the main problem. Source

Kurihara M.,The Kanagawa Rehabilitation Center
Japanese Journal of Neurosurgery | Year: 2016

The effect of rehabilitation in pediatric acquired brain injury (ABI) is often discussed. The aim of this study was to identify clinical recovery after ABI in children where such recovery was better than in adults due to the child-brain’s plasticity and development. The main disorders of pediatric ABI are traumatic brain injury (TBI), acute encephalopathy, hypoxic encephalopathy and cerebro-vascular accident (CVA). In this study, I discuss TBI cases and CVA cases because they are typical neurosurgical disorders. We enrolled patients who sustained injury and were younger than 16 years. I discuss TBI in 210 cases and CVA in 71 cases (bleeding 42 cases, infarction 29 cases). We collected data on 3 parameters: etiology, functional disturbance and prognosis. The etiology of TBI was traffic accident 151 cases, abuse 29 cases, etc. The functional disturbance after TBI was physical disability in 109 cases, mental disability in 100 cases, higher brain dysfunction in 167 cases and epilepsy in 54 cases. It is important to note that the prognosis was the worst in abuse, followed by traffic accident to a lesser degree. The etiology of intracranial bleeding was mainly rupture of an arteriovenous malformation, and that of infarction was primarily complications of TBI, intracranial vessel abnormalites and complications of some sort of operation. The functional disturbances after CVA were physical disability in 64 cases, mental disability in 22 cases, higher brain dysfunction in 57 cases and epilepsy in 11 cases. The prognosis was slightly worse in infarction than in bleeding. I discussed the effect of pediatric rehabilitation after ABI. © 2016, Japanese Congress of Neurological Surgeons. All rights reserved. Source

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