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Clinical characteristics associated with pediatric traumatic intracranial hemorrhage

Pattama Tanaanantarak1, Soraya Suntornsawat1, Srila Samphao2

  • 1Department of Radiology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

Chinese Journal of Traumatology = Zhonghua Chuang Shang Za Zhi
|March 15, 2024
PubMed

Insights

Predicting intracranial hemorrhage (ICH) in pediatric traumatic brain injury (TBI) is crucial. High-energy injuries, low Glasgow Coma Scale scores, and skull fractures significantly predict ICH on brain CT scans.

Area of Science:

  • Pediatric Traumatology
  • Neuroradiology
  • Emergency Medicine

Background:

  • Traumatic brain injury (TBI) is a major cause of morbidity and mortality in children.
  • Brain computed tomography (CT) is essential for diagnosing intracranial hemorrhage (ICH).
  • Identifying predictive clinical factors for ICH can optimize CT utilization in pediatric TBI.

Purpose of the Study:

  • To identify clinical characteristics that predict intracranial hemorrhage (ICH) on brain CT in pediatric patients with traumatic brain injury (TBI).
  • To aid clinicians in judiciously deciding on the necessity of brain CT scans for pediatric TBI cases.

Main Methods:

  • A cross-sectional study included 475 pediatric TBI patients undergoing brain CT within 24 hours of injury.
  • Clinical data and CT findings were analyzed using logistic regression.
  • Statistical significance was determined with a p-value < 0.05 using R software.

Main Results:

  • Intracranial hemorrhage (ICH) was detected in 20.6% of pediatric TBI patients.
  • Significant predictors of ICH included high blunt energy injury, motor vehicle accidents, Glasgow Coma Scale score <13, palpable skull fractures, signs of basilar skull fracture, and vomiting ≥ 3 times.
  • Odds ratios ranged from 2.04 to 7.30 for these predictive factors.

Conclusions:

  • Specific clinical factors are statistically significant predictors of intracranial hemorrhage (ICH) in pediatric traumatic brain injury (TBI).
  • These findings can assist healthcare providers in making informed decisions regarding the use of brain CT scans.
  • Optimizing brain CT use can improve diagnostic accuracy and resource allocation in pediatric TBI management.
Abstract

Keywords:
ChildrenIntracranial hemorrhagePediatricsTraumatic brain injury

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