Article

The aims of the study were to investigate (1) the impact of age at brain
insult on functional outcome and (2) the influence of insult and environmental
factors on cognitive and behavioural outcomes. METHOD: The study was a
cross-sectional, retrospective observational study, involving 138 children (76
males, 62 females; mean age 13y 1mo, SD 1y 11mo, range 10-16y) with magnetic
resonance imaging (MRI) evidence of focal brain insult sustained from the first
trimester of pregnancy to adolescence. Children underwent MRI and intellectual,
executive, behavioural, and social evaluation. Outcome predictors were insult
(lesion location, laterality, and extent, history of seizures, age at insult) and
environmental (social risk and family function) factors. RESULTS: Focal insult
before the age of 3 years was associated with poorer outcomes than insult after
the age of 3 years across all domains. For IQ outcomes, insult characteristics
and seizures were highly predictive. For executive and behavioural domains,
family function and social risk had the greatest impact. Earlier age at insult
predicted poorer social competence. INTERPRETATION Focal brain insult before age
3 years has devastating consequences for children's development. Findings suggest
that greater emphasis should be placed on providing early intervention for
children who sustain early focal brain insults.

Langue : ANGLAIS