Objective: Children (8-13 years of age) with complicated mild to severe traumatic brain injury were compared to age and sex matched orthopedically injured (OI) controls as part of Social Outcomes of Brain Injury in Kids (SOBIK) study. Although advanced MRI voxel-based quantitative analyses have been conducted on the SOBIK sample, the current study examined how clinical MRI ratings (the Scheltens et al., 1992 rating system) related to quantitative FreeSurfer (FS, v 5.3.3) findings and the WISC-IV Processing Speed Index (PSI). Data Selection: Eighty-two children with TBI and 61 children with OI were examined. Three regions of interests (ROIs) were examined using the Schelten et al. criteria: temporal horn (TH) width, choroid fissure (CF) height and hippocampal (Hipp) size. Head and body size differences were adjusted by an intracranial width (IW) measurement. Clinical ratings were compared to FS volumetric image analysis findings. Data Synthesis: TH dilation was the most reliable clinical rating metric that significantly differentiated TBI from OI, in particular the right TH (F = 2.98, p = 0.025). Likewise, right TH related to cortical volume of the right temporal lobe. Children with OI and those with severe TBI differed significantly on PSI (p = 0.03). Significant negative CF-right (r = −.61, p < .05) and TH-right (r = −.68, p < .05) correlations were observed within the severe TBI group and PSI. Hipp and IW did not significantly relate to PSI among the mild-to-moderate TBI and OI groups. Conclusion: Clinical rating of TH and CF likely provide a simple index of brain atrophy that relates to injury severity and PSI.

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Figure 1. The Query, Design, Estimate, Contrast (QDEC) FS function was used to exam the relation between cortical volume and right TH.