Predictive value of early radiological findings in inflicted traumatic brain injury.

ABSTRACT

AIM: The aim of this study was to evaluate the value of early radiological investigations in predicting the long-term neurodevelopmental outcome of patients with inflicted traumatic brain injury (ITBI). METHODS: In 28 patients with ITBI, radiological investigations were performed during the acute phase of injury (0-3 days) and during the early post-injury phase (4 days to 1 month). The clinical outcome in survivors (n = 24) was based on the Glasgow Outcome Score. RESULTS: Four of 28 infants died and five were severely disabled. Six infants had moderate disability. Detection of changes in the basal ganglia (p < 0.000005) or brainstem (p < 0.01), diffuse oedema (p < 0.005), transtentorial herniation (p < 0.01), subarachnoid haemorrhage (p < 0.05) or parenchymal injury (p < 0.05) by neuroimaging during the first 3 days, and detection of changes in the basal ganglia (p < 0.0005) or brainstem (p < 0.05) or parenchymal injury (p < 0.01) during 1 month were significantly associated with poor long-term outcome. CONCLUSION: Radiological findings during the first month were significantly associated with the long-term outcome. Especially, basal ganglia lesions were associated with a poor outcome.