title: The relation between Glasgow Coma Scale score and later cerebral atrophy in paediatric traumatic brain injury.
abstract: 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.
authors.affiliation: E.B. Singleton Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX, USA.
authors.forename: Alokananda
authors.initials: A
authors.lastname: Ghosh
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.forename: Jill V
authors.initials: JV
authors.lastname: Hunter
authors.forename: Erin D
authors.initials: ED
authors.lastname: Bigler
authors.forename: Zili
authors.initials: Z
authors.lastname: Chu
authors.forename: Xiaoqi
authors.initials: X
authors.lastname: Li
authors.forename: Ana C
authors.initials: AC
authors.lastname: Vasquez
authors.forename: Deleene
authors.initials: D
authors.lastname: Menefee
authors.forename: Ragini
authors.initials: R
authors.lastname: Yallampalli
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
mesh_terms: 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