{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:40:21Z","timestamp":1777927221168,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"17","license":[{"start":{"date-parts":[[2021,8,13]],"date-time":"2021-08-13T00:00:00Z","timestamp":1628812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:p>The identification of children with traumatic brain injury (TBI) who are at risk of death or poor global neurological functional outcome remains a challenge. Magnetic resonance imaging (MRI) can detect several brain pathologies that are a result of TBI; however, the types and locations of pathology that are the most predictive remain to be determined. Forty-two critically ill children with TBI were recruited prospectively from pediatric intensive care units at five Canadian children's hospitals. Pathologies detected on subacute phase MRIs included cerebral hematoma, herniation, cerebral laceration, cerebral edema, midline shift, and the presence and location of cerebral contusion or diffuse axonal injury (DAI) in 28 regions of interest were assessed. Global functional outcome or death more than 12 months post-injury was assessed using the Pediatric Cerebral Performance Category score. Linear modeling was employed to evaluate the utility of an MRI composite score for predicting long-term global neurological function or death after injury, and nonlinear Random Forest modeling was used to identify which MRI features have the most predictive utility. A linear predictive model of favorable versus unfavorable long-term outcomes was significantly improved when an MRI composite score was added to clinical variables. Nonlinear Random Forest modeling identified five MRI variables as stable predictors of poor outcomes: presence of herniation, DAI in the parietal lobe, DAI in the subcortical white matter, DAI in the posterior corpus callosum, and cerebral contusion in the anterior temporal lobe. Clinical MRI has prognostic value to identify children with TBI at risk of long-term unfavorable outcomes.<\/jats:p>","DOI":"10.1089\/neu.2020.7514","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T07:14:38Z","timestamp":1617174878000},"page":"2407-2418","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Magnetic Resonance Imaging Findings Are Associated with Long-Term Global Neurological Function or Death after Traumatic Brain Injury in Critically Ill Children"],"prefix":"10.1177","volume":"38","author":[{"given":"Carter","family":"McInnis","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada."},{"name":"Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9 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Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne-Marie","family":"Guerguerian","sequence":"additional","affiliation":[{"name":"Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada."},{"name":"Department of Critical Care Medicine, and Hospital for Sick Children, Toronto, Ontario, Canada."},{"name":"Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada."},{"name":"Interdepartmental Division of Critical Care, University of Toronto, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adeoye","family":"Oyefiade","sequence":"additional","affiliation":[{"name":"Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada."},{"name":"Division of Hematology\/Oncology, University of Toronto, Toronto, Ontario, 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Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keng","family":"Tay","sequence":"additional","affiliation":[{"name":"Department of Radiology, London Health Sciences Centre, London, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin D.","family":"Bigler","sequence":"additional","affiliation":[{"name":"Department of Psychological Science and Neuroscience Centre, Brigham Young University, Provo, Utah, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maureen","family":"Dennis","sequence":"additional","affiliation":[{"name":"Neuroscience and Mental Health Research Program, Hospital for Sick Children, Toronto, Ontario, Canada."},{"name":"Division of Hematology\/Oncology, University of Toronto, Toronto, Ontario, Canada."},{"name":"Department of Surgery, and University of Toronto, Toronto, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas D.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Division of Pediatric Critical Care Medicine, Department of Pediatrics, Schulich School of Medicine University of Western Ontario, Children's Hospital of the London Health Sciences Centre and the Lawson Research Institute, London, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Campbell","sequence":"additional","affiliation":[{"name":"Division of Neurology, Children's Hospital of the London Health Sciences Centre and Department of Pediatrics, Epidemiology and Clinical Neurological Sciences, Schulich School of Medicine, University of Western Ontario, London, Ontario, Canada."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Choong","sequence":"additional","affiliation":[{"name":"Division of Pediatric Intensive Care, Department of Pediatrics, McMaster Children's Hospital\u2013Hamilton Health Sciences, Hamilton, Ontario, 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