Skip to main content

Cognitive Outcomes of Patients with Traumatic Bifrontal Contusions

  • Conference paper
  • First Online:
Intracranial Pressure & Neuromonitoring XVI

Part of the book series: Acta Neurochirurgica Supplement ((NEUROCHIRURGICA,volume 126))

  • 2279 Accesses

Abstract

Objectives: We aimed to investigate the prevalence and pattern of cognitive dysfunction in patients with traumatic bifrontal contusions and their association with functional outcome.

Materials and methods: We prospectively recruited patients with bifrontal contusions in a regional neurosurgical center in Hong Kong over a 2-year period. Functional outcome was assessed by modified Rankin Scale (mRS), and cognitive outcomes were assessed by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a comprehensive neuropsychological battery.

Results: We recruited 34 patients with traumatic bifrontal contusions over a 2-year period. Nine (26%) patients had craniotomy for evacuation of left or right frontal contusions. Functional outcome using mRS was significantly correlated with cognitive outcomes using MMSE or MoCA. The effect of cognitive outcome using MMSE or MoCA persisted after adjustments of age, sex, admission Glasgow Coma Scale, and surgery. In patients who completed the comprehensive neuropsychological assessments, cognitive impairment in at least one of the neuropsychological tests was noted in 73% of them.

Conclusions: Cognitive dysfunction had a significant impact on functional outcome, and treatment strategy should be developed to minimize them.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

  1. Wong GK, Graham CA, Ng E, Yeung JH, Rainer TH, Poon WS. Neurological outcomes of neurosurgical operations for multiple trauma elderly patients in Hong Kong. J Emerg Trauma Shock. 2011;4:346–50. https://doi.org/10.4103/0974-2700.83861.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Wong GK, Yeung JH, Graham CA, Zhu XL, Rainer TH, Poon WS. Neurological outcome in patients with traumatic brain injury and its relationship with computed tomography patterns of traumatic subarachnoid hemorrhage. J Neurosurg. 2011;114:1510–5. https://doi.org/10.3171/2011.1.JNS101102.

    Article  PubMed  Google Scholar 

  3. Wong GK, Teoh J, Yeung J, Chan E, Siu E, Woo P, Rainer T, Poon WS. Outcomes of traumatic brain injury in Hong Kong: validation with the TRISS, CRASH, and IMPACT models. J Clin Neurosci. 2013;20:1693–6. https://doi.org/10.1016/j.jocn.2012.12.032.

    Article  PubMed  Google Scholar 

  4. Wong GK, Tang BY, Yeung JH, Collins G, Rainer T, Ng SC, Poon WS. Traumatic intracerebral haemorrhage: is the CT pattern related to outcome? Br J Neurosurg. 2009;23:601–5. https://doi.org/10.3109/02688690902948184.

    Article  CAS  PubMed  Google Scholar 

  5. Wong GK, Lam SW, Wong A, Ngai K, Poon WS, Mok V. Comparison of montreal cognitive assessment and mini-mental state examination in evaluating cognitive domain deficit following aneurysmal subarachnoid haemorrhage. PLoS One. 2013;8:e59946. https://doi.org/10.1371/journal.pone.0059946.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Wong GK, Ngai K, Lam SW, Wong A, Mok V, Poon WS. Validity of the Montreal Cognitive Assessment for traumatic brain injury patients with intracranial haemorrhage. Brain Inj. 2013;27:394–8. https://doi.org/10.3109/02699052.2012.750746.

    Article  PubMed  Google Scholar 

  7. Wong GK, Lam S, Ngai K, Wong A, Mok V, Poon WS, Cognitive Dysfunction after Aneurysmal Subarachnoid Haemorrhage Investigators. Evaluation of cognitive impairment by the Montreal cognitive assessment in patients with aneurysmal subarachnoid haemorrhage: prevalence, risk factors and correlations with 3 month outcomes. J Neurol Neurosurg Psychiatry. 2012;83:1112–7. https://doi.org/10.1136/jnnp-2012-302217.

    Article  PubMed  Google Scholar 

  8. Wong GK, Lam SW, Wong A, Lai M, Siu D, Poon WS, Mok V. MoCA-assessed cognitive function and excellent outcome after aneurysmal subarachnoid hemorrhage at 1 year. Eur J Neurol. 2014;21:725–30. https://doi.org/10.1111/ene.12363.

    Article  CAS  PubMed  Google Scholar 

  9. Wong GK, Lam SW, Wong A, Mok V, Siu D, Ngai K, Poon WS. Early MoCA-assessed cognitive impairment after aneurysmal subarachnoid hemorrhage and relationship to 1-year functional outcome. Transl Stroke Res. 2014;5:286–91. https://doi.org/10.1007/s12975-013-0284-z.

    Article  PubMed  Google Scholar 

  10. Wong GK, Wong R, Poon WS. Cognitive outcomes and activity of daily living for neurosurgical patients with intrinsic brain lesions: a one-year prevalence study. Hong Kong J Occup Ther. 2011;21:27–32.

    Article  Google Scholar 

  11. Hasan A, Deeb G, Rahal R, Atwi K, Mondello S, Marei HE, Gali A, Sleiman E. Mesenchymal stem cells in the treatment of traumatic brain injury. Front Neurol. 2017;8:28. https://doi.org/10.3389/fneur.2017.00028.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Zhang R, Liu Y, Yan K, Chen L, Chen XR, Li P, Chen FF, Jiang XD. Anti-inflammatory and immunomodulatory mechanisms of mesenchymal stem cell transplantation in experimental traumatic brain injury. J Neuroinflammation. 2013;10:106. https://doi.org/10.1186/1742-2094-10-106.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Wang Z, Wang Y, Wang Z, Gutkind JS, Wang Z, Wang F, Lu J, Niu G, Teng G, Chen X. Engineered mesenchymal stem cells with enhanced tropism and paracrine secretion of cytokines and growth factors to treat traumatic brain injury. Stem Cells. 2015;33:456–67. https://doi.org/10.1002/stem.1878.

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by Research and Training Fund of the Division of Neurosurgery of the Chinese University of Hong Kong.

Disclosure: None.

Conflicts of interest statement

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to George Kwok Chu Wong M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this paper

Check for updates. Verify currency and authenticity via CrossMark

Cite this paper

Wong, G.K.C., Ngai, K., Poon, W.S., Zheng, V.Z.Y., Yu, C. (2018). Cognitive Outcomes of Patients with Traumatic Bifrontal Contusions. In: Heldt, T. (eds) Intracranial Pressure & Neuromonitoring XVI. Acta Neurochirurgica Supplement, vol 126. Springer, Cham. https://doi.org/10.1007/978-3-319-65798-1_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65798-1_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65797-4

  • Online ISBN: 978-3-319-65798-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics