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

Pediatr Radiol. 2012 Aug;42(8):974-81. doi: 10.1007/s00247-012-2372-8. Epub 2012 Mar 21.

Abstract

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.

MeSH terms

  • Adolescent
  • Brain Injuries / diagnostic imaging*
  • Brain Injuries / physiopathology*
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Injury Severity Score
  • Linear Models
  • Male
  • Quality of Life*
  • Tomography, X-Ray Computed / methods*