Artikel
Intracranial lesion patterns and their association with full recovery in adolescents and young people with mild traumatic brain injury
Intrakranielle Läsionsmuster und ihr Zusammenhang mit der funktionellen Erholung bei Jugendlichen und jungen Menschen mit leichtem Schädel-Hirn-Trauma
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Veröffentlicht: | 25. Mai 2022 |
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Gliederung
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Objective: Mild traumatic brain injury (mTBI) is a very common injury in young people. It can be accompanied by structural damage to the brain which is typically detected using CT imaging. Here, we investigated how CT abnormalities and patterns relate to the long-term global functional outcome in young patients with mTBI.
Methods: All patients with mTBI (GCS 13-15) ≤24 years in the multi-center, prospectively collected, observational CENTER-TBI study were included. Patient demographics, CT findings, and GOSE scores at 12 months follow-up were retrieved. Demographical, clinical, and radiographic characteristics were analyzed. The association between CT abnormalities and functional recovery was assessed using multivariable mixed ordinal and logistic regression models.
Results: A total of 462 eligible patients with mTBI and initial brain CT from 46 study centers in Europe were included. The median age was 19 (17-22) years, and 322 (70%) were males. CT imaging showed an intracranial pathology in 171 patients (37%), most commonly subarachnoid hemorrhages, followed by contusions, and epidural hematomas. Patients with a positive CT scan were less likely to achieve a complete recovery 12 months postinjury than patients with a negative CT scan (54% vs. 77%). The presence of any CT abnormality was associated with both lower GOSE scores and incomplete recovery (GOSE <8) at 12 months follow-up, also when adjusted for demographical and clinical baseline factors.
Conclusion: In this study of young patients with mTBI, the presence of CT abnormalities was predictive of global outcome 12 months after brain injury. This might help to identify patients at risk for an incomplete recovery who might benefit from early follow-up and additional care.