Publication Type Academic Article
Authors Caliendo E, Kim N, Edasery D, Askin G, Nowak S, Gerber L, Baum K, Blackwell L, Koterba C, Hoskinson K, Kurowski B, McLaughlin M, Tlustos S, Watson W, Niogi S, Suskauer S, Shah S
Journal J Neurotrauma
Volume 38
Issue 14
Pagination 1961-1968
Date Published 03/01/2021
ISSN 1557-9042
Keywords Brain Injuries, Traumatic, Cognition Disorders, Motor Disorders, Tomography, X-Ray Computed
Abstract Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children; survivors experience long-term cognitive and motor deficits. To date, studies predicting outcome following pediatric TBI have primarily focused on acute behavioral responses and proxy measures of injury severity; unsurprisingly, these measures explain very little of the variance following heterogenous injury. In adults, certain acute imaging biomarkers help predict cognitive and motor recovery following moderate to severe TBI. This multi-center, retrospective study, characterizes the day-of-injury computed tomographic (CT) reports of pediatric, adolescent, and young adult patients (2 months to 21 years old) who received inpatient rehabilitation services for TBI (n = 247). The study also determines the prognostic utility of CT findings for cognitive and motor outcomes assessed by the Pediatric Functional Independence Measure, converted to age-appropriate developmental functional quotient (DFQ), at discharge from rehabilitation. Subdural hematomas (66%), contusions (63%), and subarachnoid hemorrhages (59%) were the most common lesions; the majority of subjects had less severe Rotterdam CT scores (88%, ≤ 3). After controlling for age, gender, mechanism of injury, length of acute hospital stay, and admission DFQ in multivariate regression analyses, the highest Rotterdam score (β = -25.2, p < 0.01) and complete cisternal effacement (β = -19.4, p < 0.05) were associated with lower motor DFQ, and intraventricular hemorrhage was associated with lower motor (β = -3.7, p < 0.05) and cognitive DFQ (β = -4.9, p < 0.05). These results suggest that direct detection of intracranial injury provides valuable information to aid in prediction of recovery after pediatric TBI, and needs to be accounted for in future studies of prognosis and intervention.
DOI 10.1089/neu.2020.7437
PubMed ID 33504256
PubMed Central ID PMC8418527
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