Comparison of subgroups based on hemorrhagic lesions between SWI and FLAIR in pediatric traumatic brain injury

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to investigate efficient ways to diagnose and predict clinical outcomes for childhood traumatic brain injury. Methods: Hemorrhagic signal intensities in nine brain regions were observed using axial fluid-attenuated inversion recovery (FLAIR) and susceptibility- weighted imaging (SWI). After having divided the subjects into mild presentation (GCS 14-15) and moderate-to-severe presentation groups (GCS ≤13), we divided the patients into three subgroups: Subgroup I, hemorrhagic foci observed only on SWI and not on FLAIR; Subgroup II, hemorrhagic foci observed on both SWI and FLAIR in the same brain regions; and Subgroup III, any cases with additional foci on SWI in other brain regions. We investigated the clinical course and compared lesion numbers and distributions of hemorrhagic lesions on SWI among the subgroups. Results: Three clinical variables (hospitalization period in intensive care unit, total days of hospitalization, and outcome based on Pediatric Cerebral Performance Category Scale score) showed significant relevance to the three subgroups. Subgroup I showed the fewest lesions followed by Subgroups II and III, respectively. In all three subgroups, lesions were most abundant in cortical regions. Lesion in the thalamus, basal ganglia, corpus callosum, and brainstem was least in Subgroup I and gradually increased in Subgroups II and III. Such distinction was more significant in the moderate-to-severe group when compared with the mild group. Conclusions: In cases of pediatric traumatic brain injury, categorizing patients into one of the above three subgroups based on hemorrhagic lesions on SWI and FLAIR is a promising method for predicting patient's clinical outcome.

Original languageEnglish
Pages (from-to)1011-1019
Number of pages9
JournalChild's Nervous System
Volume30
Issue number6
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Pediatrics
Brain
Hospitalization
Corpus Callosum
Basal Ganglia
Thalamus
Brain Stem
Intensive Care Units
Traumatic Brain Injury

Keywords

  • FLAIR
  • Hemorrhagic lesion
  • Pediatric traumatic brain injury
  • SWI

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

@article{c6b3d06c79e142468723c117eb937fda,
title = "Comparison of subgroups based on hemorrhagic lesions between SWI and FLAIR in pediatric traumatic brain injury",
abstract = "Purpose: The purpose of this study was to investigate efficient ways to diagnose and predict clinical outcomes for childhood traumatic brain injury. Methods: Hemorrhagic signal intensities in nine brain regions were observed using axial fluid-attenuated inversion recovery (FLAIR) and susceptibility- weighted imaging (SWI). After having divided the subjects into mild presentation (GCS 14-15) and moderate-to-severe presentation groups (GCS ≤13), we divided the patients into three subgroups: Subgroup I, hemorrhagic foci observed only on SWI and not on FLAIR; Subgroup II, hemorrhagic foci observed on both SWI and FLAIR in the same brain regions; and Subgroup III, any cases with additional foci on SWI in other brain regions. We investigated the clinical course and compared lesion numbers and distributions of hemorrhagic lesions on SWI among the subgroups. Results: Three clinical variables (hospitalization period in intensive care unit, total days of hospitalization, and outcome based on Pediatric Cerebral Performance Category Scale score) showed significant relevance to the three subgroups. Subgroup I showed the fewest lesions followed by Subgroups II and III, respectively. In all three subgroups, lesions were most abundant in cortical regions. Lesion in the thalamus, basal ganglia, corpus callosum, and brainstem was least in Subgroup I and gradually increased in Subgroups II and III. Such distinction was more significant in the moderate-to-severe group when compared with the mild group. Conclusions: In cases of pediatric traumatic brain injury, categorizing patients into one of the above three subgroups based on hemorrhagic lesions on SWI and FLAIR is a promising method for predicting patient's clinical outcome.",
keywords = "FLAIR, Hemorrhagic lesion, Pediatric traumatic brain injury, SWI",
author = "Choi, {Jong Il} and Bum-Joon Kim and Sung-Kon Ha and Se-Hoon Kim and Lim, {Dong Jun} and Sang-Dae Kim",
year = "2014",
month = "1",
day = "1",
doi = "10.1007/s00381-013-2349-4",
language = "English",
volume = "30",
pages = "1011--1019",
journal = "Child's Nervous System",
issn = "0256-7040",
publisher = "Springer Verlag",
number = "6",

}

TY - JOUR

T1 - Comparison of subgroups based on hemorrhagic lesions between SWI and FLAIR in pediatric traumatic brain injury

AU - Choi, Jong Il

AU - Kim, Bum-Joon

AU - Ha, Sung-Kon

AU - Kim, Se-Hoon

AU - Lim, Dong Jun

AU - Kim, Sang-Dae

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Purpose: The purpose of this study was to investigate efficient ways to diagnose and predict clinical outcomes for childhood traumatic brain injury. Methods: Hemorrhagic signal intensities in nine brain regions were observed using axial fluid-attenuated inversion recovery (FLAIR) and susceptibility- weighted imaging (SWI). After having divided the subjects into mild presentation (GCS 14-15) and moderate-to-severe presentation groups (GCS ≤13), we divided the patients into three subgroups: Subgroup I, hemorrhagic foci observed only on SWI and not on FLAIR; Subgroup II, hemorrhagic foci observed on both SWI and FLAIR in the same brain regions; and Subgroup III, any cases with additional foci on SWI in other brain regions. We investigated the clinical course and compared lesion numbers and distributions of hemorrhagic lesions on SWI among the subgroups. Results: Three clinical variables (hospitalization period in intensive care unit, total days of hospitalization, and outcome based on Pediatric Cerebral Performance Category Scale score) showed significant relevance to the three subgroups. Subgroup I showed the fewest lesions followed by Subgroups II and III, respectively. In all three subgroups, lesions were most abundant in cortical regions. Lesion in the thalamus, basal ganglia, corpus callosum, and brainstem was least in Subgroup I and gradually increased in Subgroups II and III. Such distinction was more significant in the moderate-to-severe group when compared with the mild group. Conclusions: In cases of pediatric traumatic brain injury, categorizing patients into one of the above three subgroups based on hemorrhagic lesions on SWI and FLAIR is a promising method for predicting patient's clinical outcome.

AB - Purpose: The purpose of this study was to investigate efficient ways to diagnose and predict clinical outcomes for childhood traumatic brain injury. Methods: Hemorrhagic signal intensities in nine brain regions were observed using axial fluid-attenuated inversion recovery (FLAIR) and susceptibility- weighted imaging (SWI). After having divided the subjects into mild presentation (GCS 14-15) and moderate-to-severe presentation groups (GCS ≤13), we divided the patients into three subgroups: Subgroup I, hemorrhagic foci observed only on SWI and not on FLAIR; Subgroup II, hemorrhagic foci observed on both SWI and FLAIR in the same brain regions; and Subgroup III, any cases with additional foci on SWI in other brain regions. We investigated the clinical course and compared lesion numbers and distributions of hemorrhagic lesions on SWI among the subgroups. Results: Three clinical variables (hospitalization period in intensive care unit, total days of hospitalization, and outcome based on Pediatric Cerebral Performance Category Scale score) showed significant relevance to the three subgroups. Subgroup I showed the fewest lesions followed by Subgroups II and III, respectively. In all three subgroups, lesions were most abundant in cortical regions. Lesion in the thalamus, basal ganglia, corpus callosum, and brainstem was least in Subgroup I and gradually increased in Subgroups II and III. Such distinction was more significant in the moderate-to-severe group when compared with the mild group. Conclusions: In cases of pediatric traumatic brain injury, categorizing patients into one of the above three subgroups based on hemorrhagic lesions on SWI and FLAIR is a promising method for predicting patient's clinical outcome.

KW - FLAIR

KW - Hemorrhagic lesion

KW - Pediatric traumatic brain injury

KW - SWI

UR - http://www.scopus.com/inward/record.url?scp=84902831082&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902831082&partnerID=8YFLogxK

U2 - 10.1007/s00381-013-2349-4

DO - 10.1007/s00381-013-2349-4

M3 - Article

VL - 30

SP - 1011

EP - 1019

JO - Child's Nervous System

JF - Child's Nervous System

SN - 0256-7040

IS - 6

ER -