Pediatric traumatic brain injury (TBI) is the leading cause of death among children and is a significant cause of morbidity. However, the majority of injuries are mild (Glasgow Coma Scale score 13–15) without any need for neurosurgical intervention, and clinically significant neurological decline rarely occurs. Although the question of repeat imaging within the first 24 hours has been discussed in the past, the yield of short-term follow-up imaging has never been thoroughly described. In this paper, the authors focus on the yield of routine repeat imaging for pediatric mild TBI (mTBI) at the first clinic visit following hospital discharge.

The authors conducted a retrospective review of patients with pediatric brain trauma who had been admitted to Johns Hopkins All Children’s Hospital (JHACH). Patients with mTBI were identified, and their presentation, hospital course, and imaging results were reviewed. Those pediatric patients with mTBI who had undergone no procedure during their initial admission (only conservative treatment) were eligible for inclusion in the study. Two distinct groups were identified: patients who underwent repeated imaging at their follow-up clinic visit and those who underwent only clinical evaluation. Each case was assessed on whether the follow-up imaging had changed the follow-up course.

Between 2010 and 2015, 725 patients with TBI were admitted to JHACH. Of those, 548 patients qualified for analysis (i.e., those with mTBI who received conservative treatment without any procedure and were seen in the clinic for follow-up evaluation within 8 weeks after the trauma). A total of 392 patients had only clinic follow-up, without any diagnostic imaging study conducted as part of their clinic visit, whereas the other 156 patients underwent repeat MRI. Only 1 patient had a symptomatic change and was admitted after undergoing imaging. For 30 patients (19.2%), it was decided after imaging to continue the neurosurgical follow-up, which is a change from the institutional paradigm after mTBI. None of these patients had a change in neurological status, and all had a good functional status. All of these patients had one more follow-up in the clinic with new MRI, and none of them required further follow-up.

Children with mTBI are commonly followed up in the ambulatory clinic setting. The authors believe that for children with mTBI, normal clinical examination, and no new symptoms, there is no need for routine ambulatory imaging since the clinical yield of such is relatively low.

小儿创伤性脑损伤 (TBI) 是儿童死亡的主要原因，也是发病的重要原因。然而，大多数损伤是轻微的（格拉斯哥昏迷量表评分 13-15），无需任何神经外科干预，临床上显着的神经功能衰退很少发生。尽管过去曾讨论过前 24 小时内重复成像的问题，但从未彻底描述过短期随访成像的收益。在本文中，作者关注出院后第一次就诊时儿科轻度 TBI (mTBI) 的常规重复成像率。

作者对入住约翰霍普金斯所有儿童医院 (JHACH) 的小儿脑外伤患者进行了回顾性研究。确定了 mTBI 患者，并审查了他们的表现、住院病程和影像学结果。那些在初次入院期间未接受任何手术（仅进行保守治疗）的 mTBI 儿科患者有资格参与该研究。确定了两个不同的组：在随访诊所就诊时接受重复成像的患者和仅接受临床评估的患者。评估每个病例的随访影像是否改变了随访过程。

2010 年至 2015 年间，JHACH 收治了 725 名 TBI 患者。其中，有 548 名患者符合分析条件（即 mTBI 患者接受保守治疗而未进行任何手术，并在创伤后 8 周内到诊所进行随访评估）。共有 392 名患者仅进行了临床随访，没有进行任何诊断成像研究作为其临床访问的一部分，而其他 156 名患者接受了重复 MRI。只有 1 名患者出现症状改变并在接受影像检查后入院。对于 30 名患者 (19.2%)，在成像后决定继续神经外科随访，这是 mTBI 后机构范式的改变。这些患者均未出现神经系统状态变化，且均具有良好的功能状态。

患有 mTBI 的儿童通常在门诊诊所进行随访。作者认为，对于 mTBI 患儿，临床检查正常，无新症状，无需常规动态影像学检查，临床检出率较低。