scholarly journals QuickBrain MRI for the detection of acute pediatric traumatic brain injury

2017 ◽  
Vol 19 (2) ◽  
pp. 259-264 ◽  
Author(s):  
David C. Sheridan ◽  
Craig D. Newgard ◽  
Nathan R. Selden ◽  
Mubeen A. Jafri ◽  
Matthew L. Hansen
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sensitivity And Specificity ◽  
Imaging Modality ◽  
Brain Mri ◽  
Ct Imaging ◽  
Pediatric Traumatic Brain Injury ◽  
Mri Protocol ◽  
Level I ◽  
Mass Lesions

OBJECTIVE The current gold-standard imaging modality for pediatric traumatic brain injury (TBI) is CT, but it confers risks associated with ionizing radiation. QuickBrain MRI (qbMRI) is a rapid brain MRI protocol that has been studied in the setting of hydrocephalus, but its ability to detect traumatic injuries is unknown. METHODS The authors performed a retrospective cohort study of pediatric patients with TBI who were undergoing evaluation at a single Level I trauma center between February 2010 and December 2013. Patients who underwent CT imaging of the head and qbMRI during their acute hospitalization were included. Images were reviewed independently by 2 neuroradiology fellows blinded to patient identifiers. Image review consisted of identifying traumatic mass lesions and their intracranial compartment and the presence or absence of midline shift. CT imaging was used as the reference against which qbMRI was measured. RESULTS A total of 54 patients met the inclusion criteria; the median patient age was 3.24 years, 65% were male, and 74% were noted to have a Glasgow Coma Scale score of 14 or greater. The sensitivity and specificity of qbMRI to detect any lesion were 85% (95% CI 73%–93%) and 100% (95% CI 61%–100%), respectively; the sensitivity increased to 100% (95% CI 89%–100%) for clinically important TBIs as previously defined. The mean interval between CT and qbMRI was 27.5 hours, and approximately half of the images were obtained within 12 hours. CONCLUSIONS In this retrospective pilot study, qbMRI demonstrated reasonable sensitivity and specificity for detecting a lesion or injury seen with neuroimaging (radiographic TBI) and clinically important acute pediatric TBI.

Rapid-sequence MRI for evaluation of pediatric traumatic brain injury: a systematic review

2021 ◽  
pp. 1-9
Author(s):  
Brice A. Kessler ◽  
Jo Ling Goh ◽  
Hengameh B. Pajer ◽  
Anthony M. Asher ◽  
Weston T. Northam ◽  
...  
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Mri ◽  
Skull Fractures ◽  
Pediatric Traumatic Brain Injury ◽  
Rapid Sequence ◽  
Mri Protocol ◽  
Ionizing Radiation Exposure ◽  
Pediatric Tbi

OBJECTIVE Rapid-sequence MRI (RSMRI) of the brain is a limited-sequence MRI protocol that eliminates ionizing radiation exposure and reduces imaging time. This systematic review sought to examine studies of clinical RSMRI use for pediatric traumatic brain injury (TBI) and to evaluate various RSMRI protocols used, including their reported accuracy as well as clinical and systems-based limitations to implementation. METHODS PubMed, EMBASE, and Web of Science databases were searched, and clinical articles reporting the use of a limited brain MRI protocol in the setting of pediatric head trauma were identified. RESULTS Of the 1639 articles initially identified and reviewed, 13 studies were included. An additional article that was in press at the time was provided by its authors. The average RSMRI study completion time was variable, spanning from 1 minute to 16 minutes. RSMRI with “blood-sensitive” sequences was more sensitive for detection of hemorrhage compared with head CT (HCT), but less sensitive for detection of skull fractures. Compared with standard MRI, RSMRI had decreased sensitivity for all evidence of trauma. CONCLUSIONS Protocols and uses of RSMRI for pediatric TBI were variable among the included studies. While traumatic pathology missed by RSMRI, such as small hemorrhages and linear, nondisplaced skull fractures, was frequently described as clinically insignificant, in some cases these findings may be prognostically and/or forensically significant. Institutions should integrate RSMRI into pediatric TBI management judiciously, relying on clinical context and institutional capabilities.

Clinical Utility of the Child and Adolescent Memory Profile (ChAMP) After Pediatric Traumatic Brain Injury

Assessment ◽  
2020 ◽  
pp. 107319112097685
Author(s):  
Kate Wilson ◽  
Sofia Lesica ◽  
Jacobus Donders
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Children And Adolescents ◽  
Sensitivity And Specificity ◽  
Clinical Utility ◽  
Comprehensive Evaluation ◽  
Child And Adolescent ◽  
Healthy Controls ◽  
Pediatric Traumatic Brain Injury ◽  
Post Injury

Sixty-one children and adolescents with traumatic brain injury completed the Child and Adolescent Memory Profile (ChAMP; Sherman & Brooks, 2015) within 1 to 12 months post injury. Most of the ChAMP index scores demonstrated statistically significant negative correlations with time to follow commands following traumatic brain injury. Compared with demographically matched neurologically healthy controls, selected from the ChAMP standardization sample, participants with traumatic brain injury had statistically significantly lower scores on all ChAMP index scores but sensitivity and specificity were suboptimal. We conclude that the ChAMP has modest clinical utility as part of a more comprehensive evaluation of sequelae of traumatic brain injury in children and adolescents.

scholarly journals Longitudinal Growth Curve Trajectories of Family Dynamics after Pediatric Traumatic Brain Injury in Mexico

2020 ◽  
Vol 17 (22) ◽  
pp. 8508
Author(s):  
Grace B. McKee ◽  
Laiene Olabarrieta-Landa ◽  
Paula K. Pérez-Delgadillo ◽  
Ricardo Valdivia-Tangarife ◽  
Teresita Villaseñor-Cabrera ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Growth Curve ◽  
Family Members ◽  
Family Satisfaction ◽  
Health Concern ◽  
Pediatric Traumatic Brain Injury ◽  
Large Hospital ◽  
Pediatric Tbi

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.

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