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A case-control study on the driving factors of childhood brain volume loss: What pediatricians must explore
Richard Sungura1, Gabriel Shirima1, John Spitsbergen2
1Department of Health and Biomedical Sciences, School of Life Science, Nelson Mandela- African Institution of Science and Technology, Arusha, Tanzania.
Insights
Childhood brain atrophy is linked to factors like male gender, head trauma, and birth complications. Space-occupying lesions and intracranial pressure are key drivers of this condition in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Child Development
Background:
- Brain volume loss (brain atrophy) is increasingly detected in children via CT and MRI scans.
- Severe brain atrophy can cause neurocognitive deficits affecting processing speed, reasoning, and memory, altering personality.
- Understanding factors causing pre-senile brain atrophy in children is crucial.
Purpose of the Study:
- To explore factors contributing to childhood brain atrophy.
- To utilize quantitative brain CT scan evaluation to identify these factors.
Main Methods:
- A case-control study comparing 168 children with brain atrophy to 168 age- and gender-matched controls.
- All subjects were under 18 years old and underwent brain CT scans.
- Detailed review of birth and medical history, including laboratory reports, was conducted.
Main Results:
- Significant risk factors identified include: male gender (OR=1.9), age 14-17 (OR=1.1), immaturity (OR=1.04), head trauma (OR=1.02), radiation injury (OR=1.06), and birth injury/asphyxia (OR=1.02).
- Factors like malnutrition (OR=0.97) and birth outside facility (OR=0.99) showed inverse trends.
- Maternal alcoholism and antiepileptic drugs/convulsive disorders had an OR of 1.0.
Conclusions:
- Pathological brain volume reduction in children shows a trend with increasing pediatric age.
- Space-occupying lesions and increased intracranial pressure are the most significant causes of childhood brain atrophy.
Background:
The brain volume loss also known as brain atrophy is increasingly observed among children in the course of performing neuroimaging using CT scan and MRI brains. While severe forms of brain volume loss are frequently associated with neurocognitive changes due to effects on thought processing speed, reasoning and memory of children that eventually alter their general personality, most clinicians embark themselves in managing the neurological manifestations of brain atrophy in childhood and less is known regarding the offending factors responsible for developing pre-senile brain atrophy. It was therefore the goal of this study to explore the factors that drive the occurrence of childhood brain volume under the guidance of brain CT scan quantitative evaluation.
Methods:
This study was a case-control study involving 168 subjects with brain atrophy who were compared with 168 age and gender matched control subjects with normal brains on CT scan under the age of 18 years. All the children with brain CT scan were subjected to an intense review of their birth and medical history including laboratory investigation reports.
Results:
Results showed significant and influential risk factors for brain atrophy in varying trends among children including age between 14-17(OR = 1.1), male gender (OR = 1.9), birth outside facility (OR = 0.99), immaturity (OR = 1.04), malnutrition (OR = 0.97), head trauma (OR = 1.02), maternal alcoholism (OR = 1.0), antiepileptic drugs & convulsive disorders (OR = 1.0), radiation injury (OR = 1.06), space occupying lesions and ICP (OR = 1.01) and birth injury/asphyxia (OR = 1.02).
Conclusions:
Pathological reduction of brain volume in childhood exhibits a steady trend with the increase in pediatric age, with space occupying lesions & intracranial pressure being the most profound causes of brain atrophy.
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