The relation between Glasgow Coma Scale score and later cerebral atrophy in paediatric traumatic brain injury.
OBJECTIVE
To examine initial Glasgow Coma Scale (GCS) score and its relationship with later cerebral atrophy in children with traumatic brain injury (TBI) using Quantitative Magnetic Resonance Imaging (QMRI) at 4 months post-injury. It was hypothesized that a lower GCS score would predict later generalized atrophy. As a guide in assessing paediatric TBI patients, the probability of developing chronic cerebral atrophy was determined based on the initial GCS score.


METHODS
The probability model used data from 45 paediatric patients (mean age = 13.6) with mild-to-severe TBI and 41 paediatric (mean age = 12.4) orthopaedically-injured children.


RESULTS
This study found a 24% increase in the odds of developing an abnormal ventricle-to-brain ratio (VBR) and a 27% increase in the odds of developing reduced white matter percentage on neuroimaging with each numerical drop in GCS score. Logistic regression models with cut-offs determined by normative QMRI data confirmed that a lower initial GCS score predicts later atrophy.


CONCLUSIONS
GCS is a commonly used measure of injury severity. It has proven to be a prognostic indicator of cognitive recovery and functional outcome and is also predictive of later parenchymal change.
Ghosh
Alokananda
A
E.B. Singleton Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX, USA.
Wilde
Elisabeth A
EA
Hunter
Jill V
JV
Bigler
Erin D
ED
Chu
Zili
Z
Li
Xiaoqi
X
Vasquez
Ana C
AC
Menefee
Deleene
D
Yallampalli
Ragini
R
Levin
Harvey S
HS
D000293:Adolescent; D001284:Atrophy; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D001930:Brain Injuries / Q000503:physiopathology; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016017:Odds Ratio; D011379:Prognosis; D013997:Time Factors