Research Reports - Predictive value of early radiological findings in inflicted traumatic brain injury

Koji Tanoue, Kiyoshi Matsui, Kumiko Nozawa, Noriko Aida

Acta Paediatrica, DOI: 10.1111/j.1651-2227.2012.02635.x

Aim:  The aim of this study was to evaluate the value of early radiological investigations in predicting the long-term neurodevelopmental outcome of patients with inflicted traumatic brain injury (ITBI).

Methods:  In 28 patients with ITBI, radiological investigations were performed during the acute phase of injury (0–3 days) and during the early postinjury phase (4 days to 1 month). The clinical outcome in survivors (n=24) was based on the Glasgow Outcome Score.

Results:  Four of 28 infants died and five were severely disabled. Six infants had moderate disability. Detection of changes in the basal ganglia (p < 0.000005) or brain stem (p < 0.01), diffuse edema (p < 0.005), transtentorial herniation (p < 0.01), subarachnoid hemorrhage (p < 0.05) or parenchymal injury (p < 0.05) by neuroimaging during the first three days, and detection of changes in the basal ganglia (p < 0.0005) or brain stem (p < 0.05) or parenchymal injury (p < 0.01) during one month were significantly associated with poor long-term outcome.

Conclusion:  Radiologic findings during the first month were significantly associated with the long-term outcome. Especially, basal ganglia lesions were associated with a poor outcome.

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