MRI patterns in prolonged low response states following traumatic brain injury in children and adolescents.
OBJECTIVE
To explore the relationship between location and pattern of brain injury identified on MRI and prolonged low response state in children post-traumatic brain injury (TBI).


METHODS
This observational study compared 15 children who spontaneously recovered within 30 days post-TBI to 17 who remained in a prolonged low response state.


RESULTS
92.9% of children with brain stem injury were in the low response group. The predicted probability was 0.81 for brain stem injury alone, increasing to 0.95 with a regional pattern of injury to the brain stem, basal ganglia, and thalamus.


CONCLUSIONS
Low response state in children post-TBI is strongly correlated with two distinctive regions of injury: the brain stem alone, and an injury pattern to the brain stem, basal ganglia, and thalamus. This study demonstrates the need for large-scale clinical studies using MRI as a tool for outcome assessment in children and adolescents following severe TBI.
Patrick
Peter D
PD
Department of Pediatrics, Kluge Children's Rehabilitation Center and Research Institute, University of Virginia, Charlottesville, VA 22901, USA. pdp2n@virginia.edu
Mabry
Jennifer L
JL
Gurka
Matthew J
MJ
Buck
Marcia L
ML
Boatwright
Evelyn
E
Blackman
James A
JA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001479:Basal Ganglia / Q000293:injuries; D001930:Brain Injuries / Q000150:complications / Q000473:pathology*; D001933:Brain Stem / Q000293:injuries; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D018458:Persistent Vegetative State / Q000209:etiology / Q000473:pathology; D012737:Sex Factors; D013788:Thalamus / Q000293:injuries; D014474:Unconsciousness / Q000209:etiology / Q000473:pathology*