Susceptibility weighted imaging and its relationship to outcome after pediatric traumatic brain injury.
BACKGROUND
Traumatic brain injury (TBI) sustained during childhood can cause difficulties in a wide range of physical, neurological, cognitive, social and functional domains. However, the ability of health professionals and researchers to accurately predict the outcome of pediatric TBI remains limited. The advent of advanced neuroimaging techniques shows some promise in improving outcome prediction, as they contribute to greater sensitivity in characterizing intracranial lesions underlying many cognitive and functional deficits. In this study, the relationship between lesions identified on susceptibility weighted imaging (SWI) and cognitive and functional outcomes was investigated following childhood TBI.


METHODS
Participants between 5 and 14 years of age with varying levels of TBI severity (mild, mild complicated, moderate, severe, n = 106) underwent susceptibility weighted scanning on average 1-month post-injury and completed an assessment of intellectual functioning, processing speed, and behavioral and adaptive skills 6-month post-injury.


RESULTS
More severe TBI was generally associated with poorer intellectual functioning, greater behavioral problems and lower adaptive functioning. Number and volume of SWI lesions were significantly correlated with clinical outcome variables including Glasgow Coma Score (GCS), surgical intervention, length of hospital stay and length of intubation, as well as with intellectual functioning. Together, SWI and GCS accounted for a significant, though small, proportion of the variance in intellectual quotient (IQ).


CONCLUSIONS
SWI is a sensitive technique for detecting brain lesions at all TBI severity levels and shows promise in contributing to prediction of cognitive outcomes in the initial stages post-injury.
Department of Psychology, University of Montreal, Montreal, Canada.
Miriam H
MH
Beauchamp
Richard
R
Beare
Michael
M
Ditchfield
Lee
L
Coleman
Franz E
FE
Babl
Michael
M
Kean
Louise
L
Crossley
Cathy
C
Catroppa
Keith O
KO
Yeates
Vicki
V
Anderson
D000293:Adolescent; D017668:Age of Onset; D000704:Analysis of Variance; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000473:pathology* / Q000523:psychology*; D002648:Child; D002675:Child, Preschool; D003071:Cognition / Q000502:physiology; D005260:Female; D015600:Glasgow Coma Scale; D006760:Hospitalization; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007360:Intelligence; D007361:Intelligence Tests; D007902:Length of Stay; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009483:Neuropsychological Tests; D011379:Prognosis; D011597:Psychomotor Performance / Q000502:physiology; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D014474:Unconsciousness / Q000209:etiology / Q000523:psychology