Abstract

Objective: Diffuse axonal injury (DAI), which is a type of traumatic parenchymal injury, can result in acute or chronic severe neurocognitive defects in children who have had traumatic brain injury. In this study we aimed to define which clinical and radiological parameters are related to severity of morbidity.

Material and Methods: Data was gathered about 39 children who were admitted to pediatric intensive care unit after severe trauma. Data was recorded on age, Glasgow Coma Scale (GKS), Pediatric Risk of Mortality (PRISM) score, Glasgow Outcome Scale (GOS), vital signs, laboratory findings and duration of hospital stays of children who have had magnetic resonance imaging (MRI) to diagnose DAI. Number of DAI lesions and their anatomical distribution within the brain were recorded. Parameters were compared between the groups with and without DAI. We also aimed to define clinical and radiological parameters which were related to GOS.

Results and Conclusion: Twenty nine patients had DAI lesions on MRI. In comparison of the patients with and without DAI; PRISM, GOS and GCS and also durations of hospital stay were significantly different. In the group with DAI lesions, GOS was correlated with GCS and PRISM scores as well as durations of hospital stay. Neither GOS nor GCS were found to have a relationship with total number of lesions. GCS were significantly lower in patients who had lesions in thalamus and brain stem, but no relationship could be defined between GOS and position of lesions. Results of our study demonstrate that DAI causes more severe neurocognitive defects than mild brain injuries and patients need longer durations of hospital stay and rehabilitation. Larger cohort studies including clinical and radiological data are needed in order to define factors affecting prognosis and permanent damage.

Keywords: Brain injuries, Diffuse axonal injury, Critical care

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Copyright and license

Copyright © 2020 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to cite

1.
Yetimakman F, Göçmen R. Factors Affecting Permanent Neurological Defects in Pediatric Patients with Diffuse Axonal Injury after Trauma. Turk J Pediatr Dis [Internet]. 2020 Sep. 29 [cited 2025 Aug. 23];14(5):379-84. Available from: https://turkjpediatrdis.org/article/view/656