The relation between Glasgow Coma Scale score and later cerebral atrophy in paediatric traumatic brain injury

Brain Inj. 2009 Mar;23(3):228-33. doi: 10.1080/02699050802672789.


Primary objective: To examine initial Glasgow Coma Scale (GCS) score and its relationship with later cerebral atrophy in children with traumatic brain injury (TBI) using Quantitative Magnetic Resonance Imaging (QMRI) at 4 months post-injury. It was hypothesized that a lower GCS score would predict later generalized atrophy. As a guide in assessing paediatric TBI patients, the probability of developing chronic cerebral atrophy was determined based on the initial GCS score.

Methods and procedures: The probability model used data from 45 paediatric patients (mean age = 13.6) with mild-to-severe TBI and 41 paediatric (mean age = 12.4) orthopaedically-injured children.

Results: This study found a 24% increase in the odds of developing an abnormal ventricle-to-brain ratio (VBR) and a 27% increase in the odds of developing reduced white matter percentage on neuroimaging with each numerical drop in GCS score. Logistic regression models with cut-offs determined by normative QMRI data confirmed that a lower initial GCS score predicts later atrophy.

Conclusion: GCS is a commonly used measure of injury severity. It has proven to be a prognostic indicator of cognitive recovery and functional outcome and is also predictive of later parenchymal change.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Atrophy
  • Brain / pathology*
  • Brain / physiopathology
  • Brain Injuries / physiopathology
  • Child
  • Female
  • Glasgow Coma Scale
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Odds Ratio
  • Prognosis
  • Time Factors