Computed Tomography Cerebral Perfusion to Predict Functional Outcome in Pediatric Head Injury: A Comparative Study of Voxel-Based and Whole-Brain Perfusion

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

World neurosurgery Pub Date : 2025-02-26 DOI:10.1016/j.wneu.2025.123713

Manish Agrawal, Jagadeesh Kumar, Rohit Babal, Mukesh Bhaskar, Nikhil Kumar Jain

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引用次数: 0

Abstract

Objective

This study evaluates the extent of perfusion abnormalities in pediatric patients with traumatic head injury by using computed tomography (CT) perfusion (CTP) and compares the efficacy of voxel-based and whole-brain perfusion data clinically with the functional outcome scales Glasgow Outcome Scale Extended–Pediatric Revision and modified Rankin Scale (mRS).

Methods

In this prospective study, 100 eligible patients aged 0–15 years were enrolled. Patients were categorized into having mild, moderate, and severe traumatic brain injury using the Glasgow Coma Scale. CTP scans were performed at admission and at the time of discharge. Both voxel-based and whole-brain perfusion data were acquired at 5 regions of interest: orbitofrontal cortex, internal capsule, thalamus, caudate nucleus, and sensorimotor cortex for cerebral blood perfusion. The extent of perfusion abnormalities was noted in CTP scans. The Glasgow Outcome Scale Extended–Pediatric Revision and modified Rankin Scale were used to clinically evaluate functional outcomes.

Results

Significant differences in CTP findings between voxel-based and whole-brain approaches were noted. Voxel-based scans showed superior predictive value in severe cases, whereas whole-brain scans were promising in moderate cases. Glasgow Coma Scale scores and specific CT parameters (cerebral blood flow and mean transit time.) were also significant predictors of outcomes.

Conclusions

The comparative analysis highlights the complementary roles of voxel-based and whole-brain perfusion CT in predicting functional outcomes in pediatric patients with head injury. Clinicians should consider both approaches when evaluating cerebral perfusion status and making treatment decisions. Further research is warranted to validate these findings and refine imaging protocols to optimize predictive accuracy in this vulnerable population.

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来源期刊

World neurosurgery CLINICAL NEUROLOGY-SURGERY

CiteScore

3.90

自引率

15.00%

发文量

1765

审稿时长

47 days

期刊介绍： World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS