Ghosh Alokananda, Wilde Elisabeth A, Hunter Jill V, Bigler Erin D, Chu Zili, Li Xiaoqi, Vasquez Ana C, Menefee Deleene, Yallampalli Ragini, Levin Harvey S
E.B. Singleton Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX, USA.
Brain Inj. 2009 Mar;23(3):228-33. doi: 10.1080/02699050802672789.
To examine initial Glasgow Coma Scale (GCS) score and its relationship with later cerebral atrophy in children with traumatic brain injury (TBI) using Quantitative Magnetic Resonance Imaging (QMRI) at 4 months post-injury. It was hypothesized that a lower GCS score would predict later generalized atrophy. As a guide in assessing paediatric TBI patients, the probability of developing chronic cerebral atrophy was determined based on the initial GCS score.
The probability model used data from 45 paediatric patients (mean age = 13.6) with mild-to-severe TBI and 41 paediatric (mean age = 12.4) orthopaedically-injured children.
This study found a 24% increase in the odds of developing an abnormal ventricle-to-brain ratio (VBR) and a 27% increase in the odds of developing reduced white matter percentage on neuroimaging with each numerical drop in GCS score. Logistic regression models with cut-offs determined by normative QMRI data confirmed that a lower initial GCS score predicts later atrophy.
GCS is a commonly used measure of injury severity. It has proven to be a prognostic indicator of cognitive recovery and functional outcome and is also predictive of later parenchymal change.
采用定量磁共振成像（QMRI）在创伤性脑损伤（TBI）患儿伤后4个月时，检查其初始格拉斯哥昏迷量表（GCS）评分及其与后期脑萎缩的关系。研究假设为较低的GCS评分可预测后期的广泛性萎缩。作为评估小儿TBI患者的指导，根据初始GCS评分确定发生慢性脑萎缩的概率。
概率模型使用了45例轻度至重度TBI小儿患者（平均年龄 = 13.6岁）和41例骨科受伤小儿患者（平均年龄 = 12.4岁）的数据。
本研究发现，随着GCS评分每下降一个数值，神经影像学上出现脑室与脑比率（VBR）异常的几率增加24%，白质百分比降低的几率增加27%。由标准化QMRI数据确定截断值的逻辑回归模型证实，较低的初始GCS评分可预测后期萎缩。
GCS是常用的损伤严重程度衡量指标。它已被证明是认知恢复和功能结局的预后指标，也是后期实质改变的预测指标。
