A Psychometric Evaluation of Neurobehavioral Sequelae after Head Injury.

Lee, Kyeong Seok; Park, Hyun Ja; Doh, Jae Won; Bae, Hack Gun; Yun, Il Gyu

Original Article

Journal of Korean Neurosurgical Society 1995;24(4): 422-429.

Kyeong Seok Lee, Hyun Ja Park, Jae Won Doh, Hack Gun Bae, Il Gyu Yun

¹Department of Neurosurgery, Soonchunhyang University Chonan Hospital, Chonan, Korea.
²Department of Psychiatry, Soonchunhyang University Chonan Hospital, Chonan, Korea.

ABSTRACT

We investigated neurobehavioural sequelae after head injury in consecutive 104 patients who were evaluated by psychometric examinations from 1990 to 1994. Organic brain syndrome(OBS), posttraumatic stress disorder(PTSD), and others were observed in 55 patients(52.9%), 37 patients(35.6%), and 12 patients(11.5%), respectively. OBS was more common when the initial Glasgow Coma Score was low or when there was an intradural demage(p<0.025). OBS and PTSD did not differ significantly in age, sex, cause of injury, interval from injury to psychometric examination, skull fracture, cranial operation, or the Injury Severity Score. In OBS, the mean verbal Intellegence Quotient(IQ) was 91.3, performance IQ 77.8, total IQ 84.9 and memory quotient 70.7. In PTSD, it was 101.4, 100.1, 100.9 and 77.8, respectively. Performance IQ and total IQ of OBS and PTSD differed significantly, but verbal and memory quotient did not. In OBS, the mean verbal IQ of patients with right hemispheric damage was generally higher than that of patients with the left hemispheric damage, except in vocabulary and comprehension. But that of performance IQ was the reverse. In OBS, simplification, distortion, rotation, omit, impaired judgement, labile affect, impulsivity, depression, flatness, apathy, and bluntedness were commonly observed. While somatization, hostility, frustration, faking bad, and retarded manner were more frequently found in PTSD. The burden imposed on the family is primarily attributable to neurobehavioral sequelae rather than motor or sensory deficits. We should concerned about the adequate management of neurobehavioral sequelae as much as the proper treatment of head injury during the acute period.

Key Words: Neurobehavioral sequelae; Psychometric examination; Organic brain syndrome; Posttraumatic stress disorder; Head injury