title: Computed tomography characteristics in pediatric versus adult traumatic brain injury.
abstract: OBJECTIVE
  Traumatic brain injury (TBI) is a leading cause of injury, hospitalization, and death among pediatric patients. Admission CT scans play an important role in classifying TBI and directing clinical care, but little is known about the differences in CT findings between pediatric and adult patients. The aim of this study was to determine if radiographic differences exist between adult and pediatric TBI.
  
  
  METHODS
  The authors retrospectively analyzed TBI registry data from 1206 consecutive patients with nonpenetrating TBI treated at a Level 1 adult and pediatric trauma center over a 30-month period.
  
  
  RESULTS
  The distribution of sex, race, and Glasgow Coma Scale (GCS) score was not significantly different between the adult and pediatric populations; however, the distribution of CT findings was significantly different. Pediatric patients with TBI were more likely to have skull fractures (OR 3.21, p < 0.01) and epidural hematomas (OR 1.96, p < 0.01). Pediatric TBI was less likely to be associated with contusion, subdural hematoma, subarachnoid hemorrhage, or compression of the basal cisterns (p < 0.05). Rotterdam CT scores were significantly lower in the pediatric population (2.3 vs 2.6, p < 0.001).
  
  
  CONCLUSIONS
  There are significant differences in the CT findings in pediatric versus adult TBI, despite statistical similarities with regard to clinical severity of injury as measured by the GCS. These differences may be due to anatomical characteristics, the biomechanics of injury, and/or differences in injury mechanisms between pediatric and adult patients. The unique characteristics of pediatric TBI warrant consideration when formulating a clinical trial design or predicting functional outcome using prognostic models developed from adult TBI data.
authors.affiliation: Departments of Neurology and.
authors.forename: Korak
authors.initials: K
authors.lastname: Sarkar
authors.forename: Krista
authors.initials: K
authors.lastname: Keachie
authors.forename: UyenThao
authors.initials: U
authors.lastname: Nguyen
authors.forename: J Paul
authors.initials: JP
authors.lastname: Muizelaar
authors.forename: Marike
authors.initials: M
authors.lastname: Zwienenberg-Lee
authors.forename: Kiarash
authors.initials: K
authors.lastname: Shahlaie
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D002140:California; D002648:Child; D002675:Child, Preschool; D005260:Female; D015600:Glasgow Coma Scale; D006407:Hematoma, Epidural, Cranial / Q000000981:diagnostic imaging / Q000209:etiology; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging / Q000209:etiology; D006801:Humans; D020198:Intracranial Hemorrhage, Traumatic / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed