Blood Biomarkers to Improve Management of Children With Traumatic Brain Injury

Inclusion Criteria: Children and adolescents <18 years old Consent from one of the parents of the child or fromholder of parental responsibility Consent from the child or adolescent Parental affiliationwith an appropriate health insurance system

1. TBI population

• Admission within 24 hours of the injury
• Ability to follow-up by telephone, mail or email
• For the mTBI group:
• GCS score of 13-15 on admission
• Indication for cerebral CT scan according to national or local guidelines orthe in-charge physician OR diagnosis of concussion consistent with thefourth Zurich consensus statement (9) . Concussion was defined as a complexpathophysiological process caused by a direct blow to the head, face, neck,or elsewhere on the body with an impulsive force transmitted to the head (which may or may not have involved loss of consciousness), resulting in abrain injury with one or more symptoms in one or more of the followingclinical domains: somatic, cognitive, emotional or behavioural, or sleep. Toobjectively help diagnose concussion, the validated Acute ConcussionEvaluation (ACE) questionnaire (10) for children with mTBI will be used, thepresence of ≥ 1 symptom on the ACE defines concussion.
• For the moderate or severe TBI group:
• GCS score of 3-12 on admission
• Indication for cerebral CT scan according to national or local guidelines orthe in-charge physician

2. Non-TBI control paediatric population

• Admission for any reason other than TBI
• Indication of blood sampling for their routine management
• GCS score of 15
• Otherwise healthy, i.e. without chronic pathology

Exclusion Criteria:

1. TBI population

• Time of injury unknown or exceeding 24 hours
• Blood sampling not possible within 24 hours after the injury or 6 hours after theCT scan, if applicable
• Penetrating brain injury with skull fracture
• Pre-existing neurological disorders affecting the assessment of neurologicaloutcome, seizure disorder/epilepsy, brain tumour, history of neurosurgery,stroke, encephalopathy
• Venepuncture not feasible
• Pregnant woman
• Intoxication
• No clear primary mechanism of trauma
• No possibility for transferring CT scan images to the centralised platform incase of neuroimaging only performed in an outside hospital before transfer
• Participation in another interventional research study

2. Non-TBI control paediatric population

• Pre-existing neurological disorders, seizure disorder/epilepsy, brain tumour,history or indication of neurosurgery, stroke, encephalopathy
• History of TBI
• Orthopaedic trauma or surgery within the last month
• Suspected meningitidis or encephalitis
• Venepuncture not feasible
• Pregnant woman
• Intoxication
• Participation in another interventional research study