Document Detail


Diffuse axonal injury in children: clinical correlation with hemorrhagic lesions.
MedLine Citation:
PMID:  15236400     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
An inception cohort of 40 children and adolescents with traumatic brain injury and suspected diffuse axonal injury were studied using a new high-resolution magnetic resonance imaging susceptibility-weighted technique that is very sensitive for hemorrhage. A blinded comparison was performed between the extent of parenchymal hemorrhage and initial clinical variables as well as outcomes measured at 6 to 12 months after injury. Children with lower Glasgow Coma Scale scores (< or =8, n = 30) or prolonged coma (>4 days, n = 20) had a greater average number (p = 0.007) and volume (p = 0.008) of hemorrhagic lesions. Children with normal outcomes or mild disability (n = 30) at 6 to 12 months had, on average, fewer hemorrhagic lesions (p = 0.003) and lower volume (p = 0.003) of lesions than those who were moderately or severely disabled or in a vegetative state. Significant differences also were observed when comparing regional injury to clinical variables. Because susceptibility-weighted imaging is much more sensitive than conventional T2*-weighted gradient-echo sequences in detecting hemorrhagic diffuse axonal injury, more accurate and objective assessment of injury can be obtained early after insult, and may provide better prognostic information regarding duration of coma as well as long-term outcome.
Authors:
Karen A Tong; Stephen Ashwal; Barbara A Holshouser; Joshua P Nickerson; Christopher J Wall; Lori A Shutter; Renatta J Osterdock; E M Haacke; Daniel Kido
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of neurology     Volume:  56     ISSN:  0364-5134     ISO Abbreviation:  Ann. Neurol.     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-07-05     Completed Date:  2004-08-31     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7707449     Medline TA:  Ann Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  36-50     Citation Subset:  IM    
Affiliation:
Department of Radiology, Loma Linda University Medical Center, 11234 Anderson Street, Loma Linda, CA 92354, USA. krong@ahs.llumc.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Cerebral Hemorrhage / etiology*,  pathology*
Child
Child, Preschool
Coma / etiology,  pathology
Diffuse Axonal Injury / complications*,  diagnosis,  pathology*
Female
Glasgow Coma Scale
Humans
Infant
Magnetic Resonance Imaging / methods*
Male
Predictive Value of Tests
Prognosis
Statistics as Topic
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL 062983/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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