• Alokananda Ghosh, Elisabeth A Wilde, Jill V Hunter, Erin D Bigler, Zili Chu, Xiaoqi Li, Ana C Vasquez, Deleene Menefee, Ragini Yallampalli, and Harvey S Levin.
• E.B. Singleton Department of Diagnostic Imaging, Texas Children's Hospital, Houston, TX, USA.
• Brain Inj. 2009 Mar 1; 23 (3): 228-33.

Primary ObjectiveTo 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.Methods And ProceduresThe 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.ResultsThis 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.ConclusionGCS 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.

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