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


Swanson JO, Vavilala MS, Wang J, Pruthi S, Fink J, Jaffe KM, Durbin D, Koepsell T, Temkin N, Rivara FP



Publication Info:

Pediatric Radiology, epub ahead of print:


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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