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From the Departments of Neurosurgery, Physical Medicine and Rehabilitation, and Psychiatry (Drs. Levin, Benavidez, Perachio, and Song), Baylor College of Medicine, Houston, TX; the Department of Psychology (Dr. Verger-Maestre), University of Barcelona, Spain; the Department of Radiology (Dr. Mendelsohn), University of Texas Southwestern Medical School, Dallas; and the Department of Pediatrics (Dr. Fletcher), University of Texas Health Science Center at Houston.
Address correspondence and reprint requests to Dr. Harvey S. Levin, Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, 1333 Moursund Avenue, Room A205, Houston, TX 77030.
OBJECTIVE: To study effects of closed head injury (CHI) severity on development of corpus callosum (CC) in children, using MRI.
BACKGROUND: Vulnerability of CC to diffuse axonal injury has been shown in adults and children by neuropathologic and MRI studies. Given continued development of CC through the second decade, serial MRI could characterize effects of CHI on CC growth in children.
METHODS: MRI performed at 3 and 36 months after severe (mean age = 10.3 years, n = 25) and mild to moderate (mean age = 9.7 years, n = 28) CHI. Mild to moderate and severe CHI groups did not differ in demographic features. Morphometry of T1-weighted midsagittal CC by two operators with satisfactory interrater reliability yielded uncorrected and corrected CC volume.
RESULTS: An interaction of occasion with CHI severity was present as CC area decreased from 3 to 36 months in severely injured children and increased in the mild to moderate CHI group. Uncorrected CC area was correlated with acute CHI severity and functional outcome at 36 months postinjury.
CONCLUSIONS: Morphometric measurement of CC area provides a useful index of diffuse injury, which is related to functional outcome of CHI in children.
Key words: Corpus callosum—Traumatic brain injury—Children
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