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

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.