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Title: Cerebral blood flow in children with persisting postconcussive symptoms and posttraumatic headache at 2 weeks postconcussion.
Austin Authors: Fan, Feiven;Beare, Richard;Takagi, Michael;Anderson, Nicholas;Bressan, Silvia;Clarke, Cathriona J;Davis, Gavin A ;Dunne, Kevin;Fabiano, Fabian;Hearps, Stephen J C;Ignjatovic, Vera;Parkin, Georgia;Rausa, Vanessa C;Seal, Marc;Shapiro, Jesse S;Babl, Franz E;Anderson, Vicki
Affiliation: Murdoch Children's Research Institute, Melbourne, Victoria.
Melbourne School of Psychological Sciences, University of Melbourne, Victoria.
Department of Women's and Children's Health, University of Padova, Italy.
Department of Pediatrics, University of Melbourne, Victoria.
Department of Rehabilitation Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
Institute for Clinical and Translational Research, Johns Hopkins All Children's, St. Petersburg, Florida.
School of Psychology, Deakin University, Geelong, Victoria.
Psychology Service, Royal Children's Hospital, Melbourne, Victoria, Australia.
Issue Date: 1-Jul-2023
Date: 2023
Publication information: Journal of Neurosurgery. Pediatrics 2023; 32(1)
Abstract: Persisting postconcussive symptoms (pPCS), particularly headache, can significantly disrupt children's recovery and functioning. However, the underlying pathophysiology of these symptoms remains unclear. The goal in this study was to determine whether pPCS are related to cerebral blood flow (CBF) at 2 weeks postconcussion. The authors also investigated whether variations in CBF can explain the increased risk of acute posttraumatic headache (PTH) in female children following concussion. As part of a prospective, longitudinal study, the authors recruited children 5-18 years old who were admitted to the emergency department of a tertiary pediatric hospital with a concussion sustained within 48 hours of admission. Participants underwent pseudocontinuous arterial spin labeling MRI at 2 weeks postconcussion to quantify global mean gray and white matter perfusion (in ml/100 g/min). Conventional frequentist analysis and Bayesian analysis were performed. Comparison of recovered (n = 26) and symptomatic (n = 12) groups (mean age 13.15 years, SD 2.69 years; 28 male) found no differences in mean global gray and white matter perfusion at 2 weeks postconcussion (Bayes factors > 3). Although female sex was identified as a risk factor for PTH with migraine features (p = 0.003), there was no difference in CBF between female children with and without PTH. Global CBF was not associated with pPCS and female PTH at 2 weeks after pediatric concussion. These findings provide evidence against the use of CBF measured by arterial spin labeling as an acute biomarker for pediatric concussion recovery.
DOI: 10.3171/2023.3.PEDS2339
Journal: Journal of Neurosurgery. Pediatrics
Start page: 1
End page: 8
PubMed URL: 37086163
ISSN: 1933-0715
Type: Journal Article
Subjects: Bayesian analysis
arterial spin labeling
cerebral blood flow
pediatric concussion
persisting postconcussive symptoms
posttraumatic headache
traumatic brain injury
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