Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics

Mohamed Labib Ahmed El Moghier

doi:doi:10.11648/j.ijmi.20150303.14

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Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics

Mohamed Labib Ahmed El Moghier

Published in International Journal of Medical Imaging (Volume 3, Issue 3)

Received: 8 May 2015 Accepted: 17 May 2015 Published: 28 May 2015

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Abstract

Objectives: The aim of this work is to study the relationship between the initial GCS and admission brain CT findings and MRI brain findings if indicated in head trauma patients at pediatric age group. Background: Trauma is a leading cause of death in children older than 1 year, with head trauma representing 80% or more of the injuries. In approximately 5% of head trauma cases, patients die at the site of the accident. Head trauma has a high emotional, psychosocial and economic impact because these patients often have comparatively long hospital stays. Methods: This prospective study included 100 patients with head trauma at pediatric age group; the patients were evaluated with respect to their initial GCS and admission brain CT findings and correlated with clinical data. Some patients were further evaluated with MRI of brain when needed. Results: Male to female ratio was 73:27, their ages ranged from 1 day to 18 years with a mean age of 9.1 years. Of the 100 cases included in this study 21 cases were with normal CT examination and 79 were with abnormal imaging findings. 54% of the cases classified as mild TBI, 8% of the cases classified as moderate TBI and 38% of the cases classified as severe TBI. Imaging findings such as subgaleal hematoma, skull fractures, subarachnoid hemorrhage, cerebral contusion, intracerebral hemorrhage, extra-axial blood collection and diffuse cerebral edema were observed in 79% of the patients. Conclusion: Statistical significance was observed between GCS and the imaging findings, the lower the GCS score, the more severe were the TBI and imaging findings. MRI has been shown to be superior to CT in the detection of non-hemorrhagic brain injury and cases of diffuse axonal injury.

Published in	International Journal of Medical Imaging (Volume 3, Issue 3)
DOI	10.11648/j.ijmi.20150303.14
Page(s)	63-68
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Head Trauma, CT, GCS, MRI, Pediatric

References

[1]	Cakmakci H. Essentials of trauma: head and spine. Pediatric Radiol; 39 Suppl 3:391-405 Jun 2009.
[2]	Shulman, Joshua. "Traumatic Brain Injury Infographic". Shulman DuBois LLC. Retrieved 2 August 2012
[3]	Iranmanesh F. Outcome of head trauma in children. Indian J Pediatric. May 27 2009.
[4]	Garcia JJ, Manrique MI, Trenchs Sainz, et al. [Registry of mild cranio-cerebral trauma: Multicentre study from the Spanish Association of Pediatric emergencies.]. A Pediatric (Barc), (1):31-7. May 21 2009.
[5]	Mackerle Z, Gal P. Unusual penetrating head injury in children: personal experience and review of the literature. Childs Nervous System; 25:909–13 May 19 2009.
[6]	Pinto PS, Poretti A, Meoded A, et al. Review the unique features of traumatic brain injury in children. Review of the characteristics of the pediatric skull and brain, mechanisms of trauma, patterns of injury, complications, and their imaging findings--part 2. J Neuroimaging. (2):e18-41. Epub Apr; 22 2012.
[7]	Haider AH, Crompton JG, Oyetunji T, et al. Mechanism of injury predicts case fatality and functional outcomes in pediatric trauma patients: the case for its use in trauma outcomes studies. J Pediatric Surg. Aug 2011.
[8]	Trenchs V, Curcoy AI, Castillo M, et al. Minor head trauma and linear skull fracture in infants: cranial ultrasound or computed tomography Eur J Emerg Med; 16(3):150- 2 Jun 2009.
[9]	Ringl H, Schernthaner R, Philipp MO, et al. Three-dimensional fracture visualization of multi detector CT of the skull base in trauma patients: comparison of three reconstruction algorithms. Eur Radiol; 18(1):81–91 May 14 2009.
[10]	Kochanek PM, Carney N, Adelson PD, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents-second edition. Pediatric Critical Care Med (2):252 Jan 2012.
[11]	Morgado FL, Rossi LA. Correlation between the Glasgow coma scale and computed tomography imaging findings in patients with traumatic brain injury. Radiol Bras. 2011 Jan/Fev; 44(1):35–41.
[12]	Stiell IG, Clement CM, Rowe BH et al: Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA 2005, 294(12):1511-1518.
[13]	Bouida W, Marghli S, Souissi S, et al: Prediction value of the Canadian CT head rule and the New Orleans criteria for positive head CT scan and acute neurosurgical procedures in minor head trauma: a multicenter external validation study. Ann Emerg Med 2013, 61(5):521-527
[14]	Ro YS, Shin SD, Holmes JF, et al: Comparison of clinical performance of cranial computed tomography rules in patients with minor head injury: a multicenter prospective study. AcadEmerg Med 2011, 18(6):597-604.
[15]	Guerrero JL, Thurman DJ, Sniezek JE. Emergency department visits associated with traumatic brain injury: United States, 1995-1996. Brain Inj. 2000; 14:181–6.
[16]	Jager TE, Weiss HB, Coben JH, et al. Traumatic brain injuries evaluated in U.S. emergency departments, 1992-1994. Acad Emerg Med. 2000;7: 134–40.
[17]	Hidayat SKh. Acute head trauma, an evaluation by CT scanning and conventional radiology [DMRD dissertation]. College of Medicine: Mosul Univ.; 2007.
[18]	Bordignon KC, Arruda WO. CT findings in mild head trauma: a series of 2000 patients. Arq Neuropsiquiatr. 2002; 60:204–10.
[19]	Smits M, Dippel DWJ, De Haan GG, et al. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA.2005; 294:1519–25.

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Mohamed Labib Ahmed El Moghier. (2015). Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. International Journal of Medical Imaging, 3(3), 63-68. https://doi.org/10.11648/j.ijmi.20150303.14

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ACS Style

Mohamed Labib Ahmed El Moghier. Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. Int. J. Med. Imaging 2015, 3(3), 63-68. doi: 10.11648/j.ijmi.20150303.14

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AMA Style

Mohamed Labib Ahmed El Moghier. Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. Int J Med Imaging. 2015;3(3):63-68. doi: 10.11648/j.ijmi.20150303.14

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@article{10.11648/j.ijmi.20150303.14,
  author = {Mohamed Labib Ahmed El Moghier},
  title = {Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics},
  journal = {International Journal of Medical Imaging},
  volume = {3},
  number = {3},
  pages = {63-68},
  doi = {10.11648/j.ijmi.20150303.14},
  url = {https://doi.org/10.11648/j.ijmi.20150303.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20150303.14},
  abstract = {Objectives: The aim of this work is to study the relationship between the initial GCS and admission brain CT findings and MRI brain findings if indicated in head trauma patients at pediatric age group. Background: Trauma is a leading cause of death in children older than 1 year, with head trauma representing 80% or more of the injuries. In approximately 5% of head trauma cases, patients die at the site of the accident. Head trauma has a high emotional, psychosocial and economic impact because these patients often have comparatively long hospital stays. Methods: This prospective study included 100 patients with head trauma at pediatric age group; the patients were evaluated with respect to their initial GCS and admission brain CT findings and correlated with clinical data. Some patients were further evaluated with MRI of brain when needed. Results: Male to female ratio was 73:27, their ages ranged from 1 day to 18 years with a mean age of 9.1 years. Of the 100 cases included in this study 21 cases were with normal CT examination and 79 were with abnormal imaging findings. 54% of the cases classified as mild TBI, 8% of the cases classified as moderate TBI and 38% of the cases classified as severe TBI. Imaging findings such as subgaleal hematoma, skull fractures, subarachnoid hemorrhage, cerebral contusion, intracerebral hemorrhage, extra-axial blood collection and diffuse cerebral edema were observed in 79% of the patients. Conclusion: Statistical significance was observed between GCS and the imaging findings, the lower the GCS score, the more severe were the TBI and imaging findings. MRI has been shown to be superior to CT in the detection of non-hemorrhagic brain injury and cases of diffuse axonal injury.},
 year = {2015}
}

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TY - JOUR
T1 - Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics
AU - Mohamed Labib Ahmed El Moghier
Y1 - 2015/05/28
PY - 2015
N1 - https://doi.org/10.11648/j.ijmi.20150303.14
DO - 10.11648/j.ijmi.20150303.14
T2 - International Journal of Medical Imaging
JF - International Journal of Medical Imaging
JO - International Journal of Medical Imaging
SP - 63
EP - 68
PB - Science Publishing Group
SN - 2330-832X
UR - https://doi.org/10.11648/j.ijmi.20150303.14
AB - Objectives: The aim of this work is to study the relationship between the initial GCS and admission brain CT findings and MRI brain findings if indicated in head trauma patients at pediatric age group. Background: Trauma is a leading cause of death in children older than 1 year, with head trauma representing 80% or more of the injuries. In approximately 5% of head trauma cases, patients die at the site of the accident. Head trauma has a high emotional, psychosocial and economic impact because these patients often have comparatively long hospital stays. Methods: This prospective study included 100 patients with head trauma at pediatric age group; the patients were evaluated with respect to their initial GCS and admission brain CT findings and correlated with clinical data. Some patients were further evaluated with MRI of brain when needed. Results: Male to female ratio was 73:27, their ages ranged from 1 day to 18 years with a mean age of 9.1 years. Of the 100 cases included in this study 21 cases were with normal CT examination and 79 were with abnormal imaging findings. 54% of the cases classified as mild TBI, 8% of the cases classified as moderate TBI and 38% of the cases classified as severe TBI. Imaging findings such as subgaleal hematoma, skull fractures, subarachnoid hemorrhage, cerebral contusion, intracerebral hemorrhage, extra-axial blood collection and diffuse cerebral edema were observed in 79% of the patients. Conclusion: Statistical significance was observed between GCS and the imaging findings, the lower the GCS score, the more severe were the TBI and imaging findings. MRI has been shown to be superior to CT in the detection of non-hemorrhagic brain injury and cases of diffuse axonal injury.
VL - 3
IS - 3
ER -

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Mohamed Labib Ahmed El Moghier

Department of radiology, Menofyia University, Shebin Elkom, Egypt

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APA Style

Mohamed Labib Ahmed El Moghier. (2015). Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. International Journal of Medical Imaging, 3(3), 63-68. https://doi.org/10.11648/j.ijmi.20150303.14

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ACS Style

Mohamed Labib Ahmed El Moghier. Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. Int. J. Med. Imaging 2015, 3(3), 63-68. doi: 10.11648/j.ijmi.20150303.14

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AMA Style

Mohamed Labib Ahmed El Moghier. Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics. Int J Med Imaging. 2015;3(3):63-68. doi: 10.11648/j.ijmi.20150303.14

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@article{10.11648/j.ijmi.20150303.14,
  author = {Mohamed Labib Ahmed El Moghier},
  title = {Correlation Between Brain Imaging and Glasgow Coma Scale in Traumatic Head Injury in Pediatrics},
  journal = {International Journal of Medical Imaging},
  volume = {3},
  number = {3},
  pages = {63-68},
  doi = {10.11648/j.ijmi.20150303.14},
  url = {https://doi.org/10.11648/j.ijmi.20150303.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20150303.14},
  abstract = {Objectives: The aim of this work is to study the relationship between the initial GCS and admission brain CT findings and MRI brain findings if indicated in head trauma patients at pediatric age group. Background: Trauma is a leading cause of death in children older than 1 year, with head trauma representing 80% or more of the injuries. In approximately 5% of head trauma cases, patients die at the site of the accident. Head trauma has a high emotional, psychosocial and economic impact because these patients often have comparatively long hospital stays. Methods: This prospective study included 100 patients with head trauma at pediatric age group; the patients were evaluated with respect to their initial GCS and admission brain CT findings and correlated with clinical data. Some patients were further evaluated with MRI of brain when needed. Results: Male to female ratio was 73:27, their ages ranged from 1 day to 18 years with a mean age of 9.1 years. Of the 100 cases included in this study 21 cases were with normal CT examination and 79 were with abnormal imaging findings. 54% of the cases classified as mild TBI, 8% of the cases classified as moderate TBI and 38% of the cases classified as severe TBI. Imaging findings such as subgaleal hematoma, skull fractures, subarachnoid hemorrhage, cerebral contusion, intracerebral hemorrhage, extra-axial blood collection and diffuse cerebral edema were observed in 79% of the patients. Conclusion: Statistical significance was observed between GCS and the imaging findings, the lower the GCS score, the more severe were the TBI and imaging findings. MRI has been shown to be superior to CT in the detection of non-hemorrhagic brain injury and cases of diffuse axonal injury.},
 year = {2015}
}

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