Research Reports - Association of initial CT findings with quality-of-life outcomes for traumatic brain injury in children

Jonathan O. Swanson, Monica S. Vavilala, Jin Wang, Sumit Pruthi, James Fink, Kenneth M. Jaffe, Dennis Durbin, Thomas Koepsell, Nancy Temkin and Frederick P. Rivara

Pediatric Radiology
DOI: 10.1007/s00247-012-2372-8

Background
Traumatic brain injury (TBI) is a leading cause of acquired disability in children and adolescents.

Objective
To demonstrate the association between specific findings on initial noncontrast head CT and long-term outcomes in children who have suffered TBI.

Materials and methods
This was an IRB-approved prospective study of children ages 2–17 years treated in emergency departments for TBI and who underwent a head CT as part of the initial work-up (n = 347). The change in quality of life at 12 months after injury was measured by the PedsQL scale.

Results
Children with TBI who had intracranial injuries identified on the initial head CT had a significantly lower quality-of-life scores compared to children with TBI whose initial head CTs were normal. In multivariate analysis, children whose initial head CT scans demonstrated intraventricular hemorrhage, parenchymal injury, midline shift ≥5 mm, hemorrhagic shear injury, abnormal cisterns or subdural hematomas ≥3 mm had lower quality of life scores 1 year after injury than children whose initial CTs did not have these same injuries.

Conclusion
Associations exist between findings from the initial noncontrast head CT and quality of life score 12 months after injury in children with TBI.

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