Citation

Hansen C, Battikha M, Teramoto M. Pediatr. Neurol. 2019; 90: 31-36.

Affiliation

Division of Physical Medicine & Rehabilitation, University of Utah, Salt Lake City, Utah. Electronic address: Masaru.Teramoto@hsc.utah.edu.

Copyright

(Copyright © 2019, Elsevier Publishing)

DOI

10.1016/j.pediatrneurol.2018.09.015

PMID

30415875

Abstract

OBJECTIVE: The aims of this study were: (1) to characterize mild traumatic brain injury (mTBI), mTBI with skull fracture, and complicated mTBI in school-aged children seen at a Level I pediatric trauma center and (2) to examine the nature of imaging findings seen in children with mTBI with skull fracture and those with complicated mTBI.

METHODS: A total of 1777 pediatric patients (male: 1193 or 67.1%; age = 11.1 ± 3.5 years) sustaining mTBI who presented to the Emergency Department or directly to the trauma service in the years 2010 to 2013 were identified and classified into mTBI (n = 1,319 or 74.2%), mTBI with skull fracture (n = 127 or 7.2%), and complicated mTBI (n = 331 or 18.6%). Patient characteristics and imaging findings were analyzed using descriptive statistics, Pearson's χ² test, Fisher's exact test, and logistic regression analysis.

RESULTS: In children with complicated mTBI, subdural hematoma (36.9%) was the most common finding. Of the 331 children with complicated mTBI, 241 (72.8%) had multiple findings compared with one (0.8%) of 127 children having mTBI with skull fracture (Fisher's exact P < 0.001), with logistic regression analysis revealing younger age as a potential risk factor (P < 0.01). Children sustaining a depressed or complex skull fracture were nearly twice as likely as those with simple, linear skull fracture to have intracranial abnormality.

CONCLUSIONS: Multiple radiographic findings in children sustaining mTBI with skull fracture or complicated mTBI are prevalent (72.8%), with younger age as a potential risk factor.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Glasgow Coma Scale; complicated mild traumatic brain injury; concussion; imaging findings; level I pediatric trauma center; mild traumatic brain injury; skull fracture