{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T02:40:51Z","timestamp":1792204851693,"version":"4.4.0"},"reference-count":21,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Current clinical decision rules (CDRs) guiding the use of CT scanning in pediatric traumatic brain injury (TBI) assessment generally exclude children with ventricular shunts (VSs). There is limited evidence as to the risk of abnormalities found on CT scans or clinically important TBI (ciTBI) in this population. The authors sought to determine the frequency of these outcomes and the presence of CDR predictor variables in children with VSs.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors undertook a planned secondary analysis on children with VSs included in a prospective external validation of 3 CDRs for TBI in children presenting to 10 emergency departments in Australia and New Zealand. They analyzed differences in presenting features, management and acute outcomes (TBI on CT and ciTBI) between groups with and without VSs, and assessed the presence of CDR predictors in children with a VS.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n A total of 35 of 20,137 children (0.2%) with TBI had a VS; only 2 had a Glasgow Coma Scale score < 15. Overall, 49% of patients with a VS underwent CT scanning compared with 10% of those without a VS. One patient had a finding of TBI on CT scanning, with positive predictor variables on CDRs. This patient had a ciTBI. No patient required neurosurgery. For children with and without a VS, the frequency of ciTBI was 2.9% (95% CI 0.1%\u201314.9%) compared with 1.4% (95% CI 1.2%\u20131.6%) (difference 1.5% [95% CI \u22124.0% to 7.0%]), and TBI on CT 2.9% (95% CI 0.1%\u201314.9%) compared with 2.0% (95% CI 1.8%\u20132.2%) (difference 0.9%, 95% CI \u22124.6% to 6.4%).<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n The authors\u2019 data provide further support that the risk of TBI is similar for children with and without a VS.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.7.peds2090","type":"journal-article","created":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T02:08:45Z","timestamp":1605838125000},"page":"196-202","source":"Crossref","is-referenced-by-count":4,"title":["Mild traumatic brain injury in children with ventricular shunts: a PREDICT study"],"prefix":"10.3171","volume":"27","author":[{"given":"Franz E.","family":"Babl","sequence":"first","affiliation":[{"name":"Emergency Department, Royal Children\u2019s Hospital, Melbourne;"},{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia;"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Lyttle","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia;"},{"name":"Emergency Department, Bristol Royal Hospital for Children, Bristol;"},{"name":"Faculty of Health and Life Sciences, University of the West of England, Bristol, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Phillips","sequence":"additional","affiliation":[{"name":"Emergency Department, Queensland Children\u2019s Hospital, and Child Health Research Centre, Faculty of Medicine, The University of Queensland, South Brisbane;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit","family":"Kochar","sequence":"additional","affiliation":[{"name":"Emergency Department, Women\u2019s and Children\u2019s Hospital, Adelaide;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Dalton","sequence":"additional","affiliation":[{"name":"Emergency Department, The Children\u2019s Hospital at Westmead, Sydney;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Cheek","sequence":"additional","affiliation":[{"name":"Emergency Department, Royal Children\u2019s Hospital, Melbourne;"},{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia;"},{"name":"Emergency Department, Monash Medical Centre, Melbourne;"},{"name":"Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Furyk","sequence":"additional","affiliation":[{"name":"Emergency Department, The Townsville Hospital, Townsville;"},{"name":"Emergency Department, University Hospital Geelong;"},{"name":"School of Medicine, Faculty of Health, Deakin University, Geelong, Victoria, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Neutze","sequence":"additional","affiliation":[{"name":"Emergency Department, KidzFirst Middlemore Hospital, Auckland, New Zealand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bressan","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia;"},{"name":"Department of Women\u2019s and Children\u2019s Health, University of Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Williams","sequence":"additional","affiliation":[{"name":"Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J. 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