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2017 ; 8
(54
): 92615-92620
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Clinical predictors of intracranial injuries on CT in infants younger than 2
years old with mild traumatic brain injury
#MMPMID29190942
Di G
; Liu H
; Hu X
; Chen S
; Wang Z
; Liu H
Oncotarget
2017[Nov]; 8
(54
): 92615-92620
PMID29190942
show ga
PURPOSE: Mild traumatic brain injury (TBI) is common in children. The aim of this
study was to identify clinical predictors of intracranial injuries on computed
tomography (CT) in infants younger than 2 years old with mild TBI, which allow
reducing number of imaging. RESULTS: Of 214 enrolled infants with complete data,
30 (5.8%) sustained intracranial injuries. Younger age in months, severe injury
mechanism and scalp hematomas were associated with traumatic intracranial
injuries on CT. 71 had scalp hematomas and 143 had no scalp hematoma. Within
infants with scalp hematomas, 26 sustained intracranial injuries and 45 presented
normal. Intracranial injuries were significantly correlated with larger scalp
hematomas and different scalp hematoma locations. Logistic regression analysis
showed that scalp hematoma and mechanism of injury in infants younger than 2
years old with mild TBI was related to intracranial injuries (hazard
ratio=38.291, P=0.0001; hazard ratio=0.174, P=0.001). In subgroup of mild TBI
infants with scalp hematomas, logistic regression analysis showed age, scalp
hematoma size and mechanism of injury were independently associated with
intracranial injuries (hazard ratio=0.299, P=0.032; hazard ratio=5.272, P=0.006;
hazard ratio=0.312, P=0.030). METHODS: Between 2014 and 2016, we retrospectively
enrolled infants <2 years old with mild TBI. Data recorded included age, sex,
mechanism of head injury, size and location of scalp hematoma, fracture and
intracranial injuries on CT. CONCLUSION: The characteristics of scalp hematomas
and mechanism of injury were associated with intracranial injuries. These factors
should be considered when making decisions on radiologic examinations of infants
< 2 years old with mild TBI and alternative procedures, which do not involve
ionizing radiation, should be used if appropriate.