Volumetric and morphometric MRI findings in patients with mild traumatic brain injury

Brain Injury ◽  
2016 ◽  
Vol 30 (13-14) ◽  
pp. 1683-1691 ◽  
Author(s):  
T. Hellstrøm ◽  
L. T. Westlye ◽  
A. Server ◽  
M. Løvstad ◽  
C. Brunborg ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Mri Findings

scholarly journals Day of injury CT and late MRI findings: Cognitive outcome in a paediatric sample with complicated mild traumatic brain injury

Brain Injury ◽  
2015 ◽  
Vol 29 (9) ◽  
pp. 1062-1070 ◽  
Author(s):  
Erin D. Bigler ◽  
Paul B. Jantz ◽  
Thomas J. Farrer ◽  
Tracy J. Abildskov ◽  
Maureen Dennis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Cognitive Outcome ◽  
Mri Findings

scholarly journals 361 The relationship between intracranial MRI abnormalities and post-concussive symptoms in ED patients with a normal CT: as demonstrated on the Rivermead Post Concussion Symptom Questionnaire (RPQ)

2020 ◽  
Vol 37 (12) ◽  
pp. 842.2-842
Author(s):  
Daniel Whitehouse ◽  
Sophie Richter ◽  
Stefan Winzeck ◽  
Evgenios N Kornaropoulos ◽  
Tilak Das ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Diffuse Axonal Injury ◽  
Quantitative Mri ◽  
List Type ◽  
Mri Findings ◽  
Number Of Patients ◽  
Significant Difference ◽  
Prospective Longitudinal

Aims/Objectives/BackgroundMild traumatic brain injury (TBI) is common presentation to the ED. Mild, however, is a misnomer with 10–40% of patients suffering from post-concussion symptoms for months to years following injury.1 2Patients often re-present to primary care or ED with these symptoms, and the role of repeat imaging in this cohort remains uncertain. Aims: assess TBI patients discharged from the ED with no acute intracranial findings on CT head scan, who subsequently had a research-driven MRI and documented 3-month RPQ, to determine the association between ongoing post-concussion symptoms and MRI pathology.Methods/Design91 patients in the CENTER-TBI dataset met the inclusion criteria.3 Mann-Whitney U test used to compare 3-month RPQ and MRI findings. Numbers and percentages of patients with RPQ >35 and >19 presented owing to a score of 35 predicting moderate to severe activity limitation,4 and 19 representing mean RPQ in patients with diagnosed post-concussion syndrome (PCS).2Results/Conclusions15/91 CT-ve (16.5%) patients had abnormalities on acute MRI (2 intraparenchymal haemorrhages, 13 Diffuse Axonal Injury (DAI)). No significant difference between median 3 month RPQ between MRI -ve (2.00 [IQR 0.00 – 14.00] and MRI +ve (0.00 [IQR 0.00 – 8.50]) patients (p=0.51, Mann-Whitney U test). Of patients with a RPQ >35, only 1/8 (12.5%) had a +ve MRI. Of patients with a RPQ >19 2/14 (14.3%) had +ve MRI, both DAI.No difference was found between RPQ scores of MRI positive and negative patients, suggesting no significant relationship between ongoing symptomology following mild TBI and gross MRI findings in patients with a negative acute CT. This study is limited by a small number of patients with positive neuroimaging and a lack of quantitative MRI data. Further prospective research is required to assessing a larger patient cohort and more sensitive imaging modalities to examine the utility of repeat neuroimaging in patients with ongoing concussive symptoms.ReferencesPolinder S, Cnossen MC, Real RGL, et al. A multidimensional approach to post-concussion symptoms in mild traumatic brain injury. Front. Neurol 2018;9:1113. doi:10.3389/fneur.2018.01113Ingebrigtsen T, Waterloo K, Marup-Jensen S, et al. Quantification of post-concussion symptoms 3 months after minor head injury in 100 consecutive patients. J Neurol 1998;245:609–12. doi:10.1007/s004150050254Maas AIR, Menon DK, Steyerberg EW, et al. Collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER-TBI): A prospective longitudinal observational study. Neurosurgery 2015;76:67–80. doi:10.1227/NEU.0000000000000575De Guise E, Bélanger S, Tinawi S, et al. Usefulness of the rivermead postconcussion symptoms questionnaire and the trail-making test for outcome prediction in patients with mild traumatic brain injury. Appl Neuropsychol 2016;23:213–22. doi:10.1080/23279095.2015.1038747

scholarly journals Structural and Volumetric Brain MRI Findings in Mild Traumatic Brain Injury

2020 ◽  
Vol 41 (1) ◽  
pp. 92-99 ◽  
Author(s):  
J.B. Patel ◽  
S.H. Wilson ◽  
T.R. Oakes ◽  
P. Santhanam ◽  
L.K. Weaver
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Brain Mri ◽  
Mri Findings

scholarly journals Radiologic common data elements rates in pediatric mild traumatic brain injury

Neurology ◽  
2019 ◽  
Vol 94 (3) ◽  
pp. e241-e253 ◽  
Author(s):  
Andrew R. Mayer ◽  
Daniel M. Cohen ◽  
Christopher J. Wertz ◽  
Andrew B. Dodd ◽  
Jody Shoemaker ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Incidental Findings ◽  
Large Scale ◽  
Structural Mri ◽  
Mri Findings ◽  
Common Data Elements ◽  
Data Elements

ObjectiveThe nosology for classifying structural MRI findings following pediatric mild traumatic brain injury (pmTBI) remains actively debated. Radiologic common data elements (rCDE) were developed to standardize reporting in research settings. However, some rCDE are more specific to trauma (probable rCDE). Other more recently proposed rCDE have multiple etiologies (possible rCDE), and may therefore be more common in all children. Independent cohorts of patients with pmTBI and controls were therefore recruited from multiple sites (New Mexico and Ohio) to test the dual hypothesis of a higher incidence of probable rCDE (pmTBI > controls) vs similar rates of possible rCDE on structural MRI.MethodsPatients with subacute pmTBI (n = 287), matched healthy controls (HC; n = 106), and orthopedically injured (OI; n = 71) patients underwent imaging approximately 1 week postinjury and were followed for 3–4 months.ResultsProbable rCDE were specific to pmTBI, occurring in 4%–5% of each sample, rates consistent with previous large-scale CT studies. In contrast, prevalence rates for incidental findings and possible rCDE were similar across groups (pmTBI vs OI vs HC). The prevalence of possible rCDE was also the only finding that varied as a function of site. Possible rCDE and incidental findings were not associated with postconcussive symptomatology or quality of life 3–4 months postinjury.ConclusionCollectively, current findings question the trauma-related specificity of certain rCDE, as well how these rCDE are radiologically interpreted. Refinement of rCDE in the context of pmTBI may be warranted, especially as diagnostic schema are evolving to stratify patients with structural MRI abnormalities as having a moderate injury.

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

2009 ◽  
Vol 19 (2) ◽  
pp. 47-57 ◽  
Author(s):  
Christine Parrish ◽  
Carole Roth ◽  
Brooke Roberts ◽  
Gail Davie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Psychological Health ◽  
Communication Disorders ◽  
Service Members ◽  
Patient Questionnaire ◽  
Speech Language Pathologists ◽  
Test Protocol ◽  
Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

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