• Manish Agrawal, Jagadeesh Kumar, Rohit Babal, Mukesh Bhaskar, and Nikhil Kumar Jain.
• Department of Neurosurgery, SMS Medical College and Hospital, Jaipur, Rajasthan, India. Electronic address: manishagrawal30@gmail.com.
• World Neurosurg. 2025 Jan 24: 123713123713.

ObjectiveThis study evaluates the extent of perfusion abnormalities in pediatric traumatic head injury patients by using computed tomography perfusion (CTP) and compares the efficacy of voxel based and whole brain perfusion data clinically with functional outcome scales GOSE-P and MRS.MethodologyIn this Prospective study 100 eligible patients of age group 0-15 years were enrolled. Subjects were categorized into mild, moderate and severe traumatic brain injury using GCS.CT perfusion scans were performed at admission and at time of discharge. Both voxel-based and whole brain perfusion data were acquired at five regions of interest: orbitofrontal cortex, internal capsule, thalamus, caudate nucleus, and sensorimotor cortex for cerebral blood perfusion. The extent of perfusion abnormalities were noted in CTP scans. GOSE-P and MRS were utilised to clinically evaluate functional outcomes.ResultsSignificant differences in CT perfusion findings between voxel-based and whole brain approaches were noted. Voxel-based scans demonstrated superior predictive value in severe cases, while whole brain scans were promising in moderate cases. GCS scores and specific CT parameters (CBF AND MTT) were also significant predictors of outcomes.ConclusionThe comparative analysis highlights the complementary roles of voxel-based and whole brain perfusion CT in predicting functional outcomes in pediatric head injury cases. Clinicians should consider both approaches when evaluating cerebral perfusion status and making treatment decisions. Further research is warranted to validate these findings and refine imaging protocols to optimize predictive accuracy in this vulnerable population.Copyright © 2025. Published by Elsevier Inc.

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