{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T06:57:21Z","timestamp":1793170641811,"version":"4.5.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Limited evidence exists on the utility of repeat neuroimaging in children with mild traumatic brain injuries (mTBIs) and intracranial injuries (ICIs). Here, the authors identified factors associated with repeat neuroimaging and predictors of hemorrhage progression and\/or neurosurgical intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors performed a multicenter, retrospective cohort study of children at four centers of the Pediatric TBI Research Consortium. All patients were \u2264 18 years and presented within 24 hours of injury with a Glasgow Coma Scale score of 13\u201315 and evidence of ICI on neuroimaging. The outcomes of interest were 1) whether patients underwent repeat neuroimaging during index admission, and 2) a composite outcome of progression of previously identified hemorrhage \u2265 25% and\/or repeat imaging as an indication for subsequent neurosurgical intervention. The authors performed multivariable logistic regression and report odds ratios and 95% confidence intervals.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 1324 patients met inclusion criteria; 41.3% of patients underwent repeat imaging. Repeat imaging was associated with clinical change in 4.8% of patients; the remainder of the imaging tests were for routine surveillance (90.9%) or of unclear prompting (4.4%). In 2.6% of patients, repeat imaging findings were reported as an indication for neurosurgical intervention. While many factors were associated with repeat neuroimaging, only epidural hematoma (OR 3.99, 95% CI 2.22\u20137.15), posttraumatic seizures (OR 2.95, 95% CI 1.22\u20137.41), and age \u2265 2 years (OR 2.25, 95% CI 1.16\u20134.36) were significant predictors of hemorrhage progression and\/or neurosurgery. Of patients without any of these risk factors, none underwent neurosurgical intervention.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Repeat neuroimaging was commonly used but uncommonly associated with clinical deterioration. Although several factors were associated with repeat neuroimaging, only posttraumatic seizures, age \u2265 2 years, and epidural hematoma were significant predictors of hemorrhage progression and\/or neurosurgery. These results provide the foundation for evidence-based repeat neuroimaging practices in children with mTBI and ICI.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.2.peds22393","type":"journal-article","created":{"date-parts":[[2023,4,1]],"date-time":"2023-04-01T02:51:26Z","timestamp":1680317486000},"page":"26-34","source":"Crossref","is-referenced-by-count":4,"title":["Toward rational use of repeat imaging in children with mild traumatic brain injuries and intracranial injuries"],"prefix":"10.3171","volume":"32","author":[{"given":"Gabrielle W.","family":"Johnson","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob K.","family":"Greenberg","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew T.","family":"Hale","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranbir","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madelyn","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Dayton Children\u2019s Hospital, Dayton, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Belal","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawyon","family":"Baygani","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randi E.","family":"Foraker","sequence":"additional","affiliation":[{"name":"Medicine,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher R.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Emergency Medicine, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"Surgery, Washington University School of Medicine in St. Louis, Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie L.","family":"Ackerman","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, Indiana;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Noje","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Jackson","sequence":"additional","affiliation":[{"name":"Neurological Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin C.","family":"Burns","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina M.","family":"Sayama","sequence":"additional","affiliation":[{"name":"Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan R.","family":"Selden","sequence":"additional","affiliation":[{"name":"Neurological Surgery, Oregon Health & Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shobhan","family":"Vachhrajani","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Dayton Children\u2019s Hospital, Dayton, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chevis N.","family":"Shannon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Alabama at Birmingham Heersink School of Medicine, Birmingham, Alabama;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"Departments of Emergency Medicine and"},{"name":"Pediatrics, University of California, Davis, School of Medicine, Sacramento, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David D.","family":"Limbrick","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Pediatrics","first-page":"483","article-title":"Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States","volume":"118","author":"Schneier AJ","year":"2006","unstructured":"Schneier AJ, Shields BJ, Hostetler SG, Xiang H, Smith GA. 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