A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Arts in Clinical Psychology / This study investigated the emotional functioning of people who had been diagnosed as having traumatic brain injuries (TBI) of the frontal lobes. This was done with a view to examining whether there were changes in the emotional functioning of people with TBI in the period following their injuries. The pre-injury (or premorbid) emotional functioning of the respondents with TBI was assessed retrospectively through self-reports, which were compared with the ratings by the primary and secondary care-givers of these respondents. The current (post-injury) emotional functioning of the participants with TBI was also assessed through self-reports and the ratings by the primary and secondary care-givers. (abbreviation abstract) / Andrew Chakane 2019

published_or_final_version / Paediatrics / Doctoral / Doctor of Philosophy

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Thesis (Ph. D.)--York University, 2000. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 112-127). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ59153.

Thesis (Ph. D.)--York University, 1999. Graduate Programme in Philosophy. / Typescript. Includes bibliographical references (leaves 81-87). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://wwwlib.umi.com/cr/yorku/fullcit?pNQ43457.

Haemostasis is an important aspect in neurosurgical operations for the achievement of good outcome. Bipolar coagulation is an extensively used haemostatic technique in modern neurosurgery but it may also cause iatrogenic brain trauma due to thermal injury. Published studies on coagulation-induced brain injury on a histological level are, however, limited. The present study aimed at investigating the extent of inflammatory and glial responses caused by different settings of bipolar coagulation using an animal model. It also investigated whether and how pre-operative treatment with dexamethasone or progesterone, both known to have neuro-protective effects, would modulate gliosis and macrophage infiltration induced by bipolar coagulation. The study consisted of two parts. The first part investigated the astrocytic and macrophage responses after bipolar coagulation at different power settings. 45 Sprague-Dawley rats received craniotomy, followed by bipolar coagulation at different power output settings (mock operation as control, 20W and 40W) over the rat cortex for a standardized duration of two seconds. On day 3, day 7 and day 28, brain sections were assessed by immunohistochemical staining for GFAP (astrocytes) and ED1 (macrophages). Quantification of outcome by random field cell counting under light microscopy was performed. The second part of the study used another 45 male Sprague-Dawley rats, divided into three treatment groups: Group 1 received the vehicle agents only (Control); Group 2 received progesterone 20mg/kg; Group 3 received dexamethasone 1 mg/kg. All treatments were given intraperitoneally two hours before craniotomy. The animals received bipolar coagulation at 40W for a standardized duration of two seconds. On day 1, 3 and 7, brain sections were assessed by immunohistochemical staining for GFAP and ED1. Quantification of outcome by random field cell counting under light microscopy was performed. T2-weighted magnetic resonance imaging for the animals on day 3 was also performed. The results showed that bipolar coagulation was associated with significant glial and inflammatory responses that correlated with power output. Progesterone and dexamethasone were both effective in reducing the glial hypertrophy and macrophage infiltration associated with bipolar coagulation. Dexamethasone had an additional advantage of reducing brain oedema and cavity formation. The findings suggested that progesterone and dexamethasone could be further explored as potential protective and/or remedial agents for bipolar coagulation-induced brain trauma sustained during neurosurgical procedures. / published_or_final_version / Surgery / Master / Master of Research in Medicine

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The purpose of this study was to determine if the Glasgow Coma Scale (GCS) provides a valid indication of severity after closed head injury. A second purpose was to determine the nature of the deficits seen with head injured persons shortly after injury.The subjects were 69 patients ages 13 through 26 selected from consecutive closed head injury admissions to a large acute care hospital. The subjects received comprehensive neuropsychological testing after having passed the Galveston Orientation and Amnesia Test.Two a priori hypotheses were specified for each of eight neuropsychological test groupings (i.e., motor, memory, visuographic, achievement, abstraction and concept formation, language, problem solving, and psychometric intelligence). For each of the eight test groupings two, one-way multivariate analyses of covariance (MANCOVA) were used to determine statistical significance. Premorbid IQ was used as a covariate in all of the analyses. Specifically, these a priori contrasts were GCS group (8 compared with GCS group 9-15 and GCS group 9-12 compared with GCS group 13-15. Each of the significant MANCOVA tests was followed with discriminant analysis.The results revealed that 15 out of the 16 null hypotheses were rejected (p<.05 or less) thus providing clear evidence for the usefulness of the GCS as an indicator of the severity of injury. Most notable of the results is that the GCS group comparison of 9-12 and 13-15 reached significance in seven of the eight comparisons. Given this finding, there seems justification for the GCS division of 9-12 denoting a moderately injured group and 13-15 denoting a mildly injured group as was proposed in previous research. Redundancy indexes of 6% to 25% were obtained which indicated small to relatively large effect sizes for the various criterion variates.With discriminant analysis it was determined that accurate classification into GCS groups could be achieved in 64% to 94% of the cases based upon a combination of premorbid IQ and the criterion variates. This represented an increase in classification accuracy of from 13% to 51%to be over what could be accomplished with knowledge of the premorbid IQ alone. The motor test composite, problem solving test composite and abstraction and concept formation composite revealed the highest rates of reclassification.