[Constructional apraxia in patients with closed head injury].

Introduction: Constructional apraxia is a disorder characterized by an inability to join the elements into a unity. It has not been studied much in patients with closed head injury (CHI).

Methods: Forty-one patients with CHI were examined, of which 11 (26.83%) were with the right-sided, 12 (29.27%) with the left-sided, and 18 (43.90%) with bilateral lesion using the Wechsler Individual Intelligence Test (VITI) - Serbian version, Rey Complex Figure (RCF) test, Trail Making Test - TMT A and B, and the Wisconsin Card Sorting Test (WCST).

Results: Intelligence quotient (IQ) was significantly higher in the patients with the right-sided (95.27) and bilateral cerebral lesions (87.56) than in the left-sided (84.42). RCF scores did not show any significant difference regarding the side of the lesion, but was numerically the lowest scores were in patients with bilateral brain damage. Patients with left-sided lesions had the score of 30.63, right-sided of 28.68, and bilateral of 27.39. TMT B showed a significantly lower result in patients with the left-sided (196.50 seconds) and bilateral lesions (192.07 seconds) compared to the right-sided (140.14 seconds). WCST scores were not significantly different regarding the side of the lesion, but the absolute value of the categories was less than expected.

Conclusion: Constructional apraxia was more frequently present in the patients with CHI than it was previously considered. The use of sensitive tests can show the presence of the disorder mainly in bilateral, but also in unilateral lesions.