Measuring Poor Outcome Risk in Children with Head Trauma

Diffusion-weighted imaging (DWI) can help doctors identify children at risk for poor outcome following non-accidental head trauma, according to a study by Daniel Y. Suh, M.D., from the department of neurologic surgery at Emory University (Atlanta, GA, USA). The study was presented at the annual meeting of the Congress of Neurological Surgeons in San Diego (CA, USA).

DWI is a magnetic resonance imaging (MRI) technique that maps water motion in the brain. Dr. Suh examined the medical records of children under the age of two who had non-accidental head trauma. Of these, 20 had undergone a DWI scan within five days of presentation, which showed that 18 had presumed head trauma and two had suspected head trauma. Computed tomography (CT) scans and conventional MRI as well as DWI were evaluated and compared. Dr. Suh found that DWI revealed more extensive brain injury than conventional MRI and showed injuries not seen on conventional MRI in 81% of positive cases. Follow-up CT scans were consistent with the pattern and extent of injury shown by DWI, including injuries seen only on DWI and not demonstrated on admission CT or conventional MRI.

Early use of DWI provided an indication of severity that was more complete than any other imaging technique, according to Dr. Suh, and DWI severity correlated significantly with poor outcome. His study concluded that DWI may have broad implications in the early detection of infarction in children and enhances the sensitivity of conventional MRI.