Medical Student Research Fellowship for Summer 2010

Mentor: Darryl Miles, M.D.
Department: Pediatrics
Room number: C11.204
Mail Code: 9063
Phone number: (214) 456-7969
E-mail: darryl.miles@utsouthwestern.edu
Project title: Long-term Developmental Outcome Prediction in Children After Traumatic Brain Injury Using CT Based Classification Criteria

Human subjects IRB approved project number: 012005-010
Animal subjects IRB approved project number: (N/A)
Project Type: patient-based research

Brief Description of Project:

Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in children over the age of one. Children who suffer moderate and severe TBI are often left with permanent sequelae resulting in lifelong disabilities affecting the individual, their family and society as a whole.

Accurate prediction of long-term developmental outcome in the early hours after injury is useful as an adjunct to clinical decision-making and patient selection for therapeutic trials. Previous clinical variables such as age, Glasgow Coma Score, pupil reactivity, Injury Severity Scores and computed tomography (CT) classification have been shown to be independent predictors of outcome in adults. CT based classification was introduced in 1991 based upon a simple graded 6 point scale to predict intracranial hypertension and mortality, however this scale is incomplete and was not developed for children. Recently, more comprehensive CT classifications have been proposed to include a more complete description of the injury pattern. Analysis of outcome using brain CT imaging has been understudied in children and there are currently no large studies evaluating the predictive power of more recent CT classification on the neurodevelopmental outcome after TBI. In a separate prospective study of children with moderate and severe TBI at Children's Medical Center Dallas, we have prospectively collected imaging data, data on injury severity, hospital course and neuropsychological outcome measures in over 100 children ages 0-13 with TBI.

The student will be primarily involved in analysis of brain CT images collected in the above-mentioned study. Using DICOM software, the student will learn how to accurately read and score brain images and measure lesion volume collected on CT sequences. The student will also become familiar with statistical methodologies to then correlate CT characteristics with functional outcome measures. I have secured space in a computer room adjacent to my office in C3.325 complete with PC, monitor and desk. The student will also be allowed to participate in monthly meetings of our Brain Nerve and Injury Center encompassing other areas of research in pediatric neurologic injury. In addition, the student may attend weekly meetings at Parkland Memorial Hospital at the Center for Traumatic Brain Injury where research in adult TBI is presented and discussed.

Previous Research Activities or Publications with Medical Students:
Emily Smitherman
Abstract Accepted: National Neurotrauma Meeting, June, 2010, Predicting Outcome After Pediatric Traumatic Brain Injury Using Quantitative MRI Lesion Volume Analysis