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Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma

Young children with severe traumatic brain injury (TBI) have frequently been excluded from studies due to age and/or mechanism of injury. Magnetic resonance imaging (MRI) is now frequently being utilized to detect parenchymal injuries and early cerebral edema. We sought to assess MRI findings in inf...

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Autores principales: Ferguson, Nikki Miller, Rebsamen, Susan, Field, Aaron S., Guerrero, Jose M., Rosario, Bedda L., Broman, Aimee T., Rathouz, Paul J., Bell, Michael J., Alexander, Andrew L., Ferrazzano, Peter A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322188/
https://www.ncbi.nlm.nih.gov/pubmed/35884076
http://dx.doi.org/10.3390/children9071092
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author Ferguson, Nikki Miller
Rebsamen, Susan
Field, Aaron S.
Guerrero, Jose M.
Rosario, Bedda L.
Broman, Aimee T.
Rathouz, Paul J.
Bell, Michael J.
Alexander, Andrew L.
Ferrazzano, Peter A.
author_facet Ferguson, Nikki Miller
Rebsamen, Susan
Field, Aaron S.
Guerrero, Jose M.
Rosario, Bedda L.
Broman, Aimee T.
Rathouz, Paul J.
Bell, Michael J.
Alexander, Andrew L.
Ferrazzano, Peter A.
author_sort Ferguson, Nikki Miller
collection PubMed
description Young children with severe traumatic brain injury (TBI) have frequently been excluded from studies due to age and/or mechanism of injury. Magnetic resonance imaging (MRI) is now frequently being utilized to detect parenchymal injuries and early cerebral edema. We sought to assess MRI findings in infants with severe TBI, and to determine the association between specific MRI findings and mechanisms of injury, including abusive head trauma (AHT). MRI scans performed within the first 30 days after injury were collected and coded according to NIH/NINDS Common Data Elements (CDEs) for Neuroimaging in subjects age < 2 years old with severe TBI enrolled in the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial. Demographics and injury characteristics were analyzed. A total of 81 children were included from ADAPT sites with MRI scans. Median age was 0.77 years and 57% were male. Most common MRI finding was ischemia, present in 57/81 subjects (70%), in a median of 7 brain regions per subject. Contusion 46/81 (57%) and diffuse axonal injury (DAI) 36/81 (44.4%) subjects followed. Children were dichotomized based on likelihood of AHT with 43/81 subjects classified as AHT. Ischemia was found to be significantly associated with AHT (p = 0.001) and “inflicted” injury mechanism (p = 0.0003). In conclusion, the most common intracerebral injury seen on MRI of infants with severe TBI was ischemia, followed by contusion and DAI. Ischemia was associated with AHT, and ischemia affecting > 4 brain regions was predictive of AHT.
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spelling pubmed-93221882022-07-27 Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma Ferguson, Nikki Miller Rebsamen, Susan Field, Aaron S. Guerrero, Jose M. Rosario, Bedda L. Broman, Aimee T. Rathouz, Paul J. Bell, Michael J. Alexander, Andrew L. Ferrazzano, Peter A. Children (Basel) Article Young children with severe traumatic brain injury (TBI) have frequently been excluded from studies due to age and/or mechanism of injury. Magnetic resonance imaging (MRI) is now frequently being utilized to detect parenchymal injuries and early cerebral edema. We sought to assess MRI findings in infants with severe TBI, and to determine the association between specific MRI findings and mechanisms of injury, including abusive head trauma (AHT). MRI scans performed within the first 30 days after injury were collected and coded according to NIH/NINDS Common Data Elements (CDEs) for Neuroimaging in subjects age < 2 years old with severe TBI enrolled in the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial. Demographics and injury characteristics were analyzed. A total of 81 children were included from ADAPT sites with MRI scans. Median age was 0.77 years and 57% were male. Most common MRI finding was ischemia, present in 57/81 subjects (70%), in a median of 7 brain regions per subject. Contusion 46/81 (57%) and diffuse axonal injury (DAI) 36/81 (44.4%) subjects followed. Children were dichotomized based on likelihood of AHT with 43/81 subjects classified as AHT. Ischemia was found to be significantly associated with AHT (p = 0.001) and “inflicted” injury mechanism (p = 0.0003). In conclusion, the most common intracerebral injury seen on MRI of infants with severe TBI was ischemia, followed by contusion and DAI. Ischemia was associated with AHT, and ischemia affecting > 4 brain regions was predictive of AHT. MDPI 2022-07-21 /pmc/articles/PMC9322188/ /pubmed/35884076 http://dx.doi.org/10.3390/children9071092 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ferguson, Nikki Miller
Rebsamen, Susan
Field, Aaron S.
Guerrero, Jose M.
Rosario, Bedda L.
Broman, Aimee T.
Rathouz, Paul J.
Bell, Michael J.
Alexander, Andrew L.
Ferrazzano, Peter A.
Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title_full Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title_fullStr Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title_full_unstemmed Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title_short Magnetic Resonance Imaging Findings in Infants with Severe Traumatic Brain Injury and Associations with Abusive Head Trauma
title_sort magnetic resonance imaging findings in infants with severe traumatic brain injury and associations with abusive head trauma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9322188/
https://www.ncbi.nlm.nih.gov/pubmed/35884076
http://dx.doi.org/10.3390/children9071092
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