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Vol. 27. Num. 3.May - June 2016
Pages 103-154
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Vol. 27. Num. 3.May - June 2016
Pages 103-154
Case Report
DOI: 10.1016/j.neucir.2015.09.001
Adolescents with vascular frontal lesion: A neuropsychological follow up case study
Adolescentes con lesión vascular frontal: seguimiento neuropsicológico de estudio de casos
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Clara L. Cháveza,b,c,
Corresponding author
clara.chavezarana@mcri.edu.au

Corresponding author.
, Guillermina Yáñeza, Cathy Catroppab,c, Sulema Rojasa, Erick Escartina, Stephen J.C. Hearpsb, Antonio Garcíad
a Universidad Nacional Autónoma de México, FES Iztacala, México, D.F., Mexico
b Child Neuropsychology, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
c University of Melbourne, Victoria, Australia
d Medical Unit of High Specialty “La Raza” IMSS, Paediatric Neurosurgery Service, México, D.F., Mexico
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Tables (3)
Table 1. Demographic characteristics of the participants.
Table 2. Significant clinical changes in cognitive functions, standard scores, and reliable changes index.
Table 3. Significant clinical changes in executive function, standard scores and reliable change indexes.
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Abstract

The objective of this research was to identify clinically significant changes in cognitive functions in three adolescents who underwent surgery for resection of a focal vascular lesion in the frontal lobe. Cognitive functions, executive function, behavior regulation, emotion regulation, and social abilities were assessed prior to surgery, six and 24 months post-discharge. Significant clinical changes were observed during all the assessments. Cognitive changes after surgery are not homogeneous. Most of the significant clinical changes were improvements. Especially the significant clinical changes presented in EF domains were only improvements; these results suggest that EF were affected by the vascular lesion and benefitted by the surgery. After resection of a vascular lesion between 15 and 16 years of age the affected executive functions can continue the maturation process. Our results highlight the importance that assessments must include emotional aspects, even if deficits in these domains are not presented in the acute phase. Rehabilitation methods should promote the development of skills that help patients and their families to manage the emotional and behavioral changes that emerge once they are discharged from the hospital.

Keywords:
Adolescents
Executive functions
Brain lesions
Neurosurgery
Arteriovenous malformations
Cavernous angioma
Resumen

El objetivo de este estudio fue identificar cambios clínicamente significativos en las funciones cognoscitivas de tres adolescentes que fueron intervenidos quirúrgicamente para resección de una lesión vascular focal en el lóbulo frontal. Se midieron funciones cognoscitivas, funciones ejecutivas, regulación conductual, regulación emocional y habilidades sociales en tres momentos, antes de la cirugía, 6 y 24 meses después de la cirugía. Se observaron cambios clínicamente significativos durante los tres momentos de evaluación. Los cambios cognoscitivos después de la cirugía no son homogéneos. La mayoría de los cambios fueron incrementos. Especialmente los cambios clínicamente significativos presentados en funciones ejecutivas fueron mejoras, los resultados sugieren que la resección de una lesión vascular entre los 15 y 16 años de edad permite la recuperación de las funciones ejecutivas. Nuestros resultados señalan la importancia de incluir aspectos emocionales en la evaluación, aún si no se presentaron alteraciones emocionales en la fase aguda. Se sugiere que los métodos de rehabilitación apoyen a los pacientes y a sus familias a manejar los cambios emocionales y conductuales que surgen una vez que son dados de alta del hospital.

Palabras clave:
Adolescentes
Funciones ejecutivas
Lesiones cerebrales
Neurocirugía
Malformaciones arteriovenosas
Hemangioma cavernoso

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