Value of MRI in paediatric closed head injury

Children (and less commonly adults) with a low level of conciousness following acute head injury who have a normal CT sean are often assumed to have diffuse axonal injury of the brain. MRI may be appropriate in the subacute setting as it may demonstrate findings highly suggestive of such injury, as well as other findings not identified on CT. These findings may aid clinicians in determining prognosis. We demonstrate typical findings on various MR sequences using an index case.

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Lateral impact in closed head injury: A substantially increased risk for diffuse axonal injury—A preliminary study

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2007.01.006 ◽

2007 ◽

Vol 35 (3) ◽

pp. 142-146 ◽

Cited By ~ 10

Author(s):

Roger Arthur ZWAHLEN ◽

Ludwig LABLER ◽

Otmar TRENTZ ◽

Klaus Wilhelm GRÄTZ ◽

Lucas M. BACHMANN

Keyword(s):

Head Injury ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Closed Head Injury ◽

Lateral Impact ◽

Increased Risk ◽

Closed Head ◽

Preliminary Study

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Cranial MR Imaging and Cerebral 99MTC HM-PAO-Spect in Patients with Subacute or Chronic Severe Closed Head Injury and Normal CT Examinations

Acta Radiologica ◽

10.1177/028418519303400613 ◽

1993 ◽

Vol 34 (6) ◽

pp. 593-599 ◽

Cited By ~ 22

Author(s):

L. Prayer ◽

D. Wimberger ◽

W. Oder ◽

J. Kramer ◽

E. Schindler ◽

...

Keyword(s):

Head Injury ◽

Outcome Prediction ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Closed Head Injury ◽

Ct Scans ◽

Cerebral Damage ◽

Injury Patterns ◽

Cranial Ct ◽

Closed Head

Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99mTc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOS) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction.

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Diffusion-Weighted Imaging for the Evaluation of Diffuse Axonal Injury in Closed Head Injury

Journal of Computer Assisted Tomography ◽

10.1097/00004728-200301000-00002 ◽

2003 ◽

Vol 27 (1) ◽

pp. 5-11 ◽

Cited By ~ 168

Author(s):

Thierry A. G. M. Huisman ◽

A. Gregory Sorensen ◽

Klaus Hergan ◽

R. Gilberto Gonzalez ◽

Pamela W. Schaefer

Keyword(s):

Head Injury ◽

Diffusion Weighted Imaging ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Closed Head Injury ◽

Diffusion Weighted ◽

Closed Head

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Acute Tissue Tear Hemorrhages of the Brain: Computed Tomography and Clinicopathological Correlations

Neurosurgery ◽

10.1227/00006123-199008000-00006 ◽

1990 ◽

Vol 27 (2) ◽

pp. 208-213 ◽

Cited By ~ 30

Author(s):

James E. Wilberger ◽

William E. Rothfus ◽

Janet Tabas ◽

Andrew L. Goldberg ◽

Ziad L. Deeb

Keyword(s):

Computed Tomography ◽

Head Injury ◽

Head Injuries ◽

Diffuse Axonal Injury ◽

Closed Head Injury ◽

Sensitive Information ◽

Computed Tomographic ◽

Clinicopathological Correlations ◽

Closed Head ◽

The Brain

Abstract Tissue tear hemorrhages (TTHs) are often seen on high-resolution computed tomographic scans after closed head injury. Generally, TTHs have been thought to be visible manifestations of more severe forms of diffuse axonal injury and thus portend a poor prognosis. Computed tomographic scans from 600 patients with head injuries were reviewed: 48 (8%) were found to have TTHs. The clinical spectrum of TTHs was characterized. No direct relationship could be established between either the presence or the number of TTHs and the severity and/or outcome from the head injury in this group, except that patients with TTHs in both the brain stem and the corpus callosum uniformly had a poor outcome. Magnetic resonance imaging provided more sensitive information than computed tomography in evaluating TTHs.

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Distribution of Forebrain Diffuse Axonal Injury Following Inertial Closed Head Injury in Miniature Swine

Experimental Neurology ◽

10.1006/exnr.1994.1067 ◽

1994 ◽

Vol 126 (2) ◽

pp. 291-298 ◽

Cited By ~ 81

Author(s):

Douglas T. Ross ◽

David F. Meaney ◽

Michelle K. Sabol ◽

Douglas H. Smith ◽

Thomas A. Gennarelli

Keyword(s):

Head Injury ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Closed Head Injury ◽

Miniature Swine ◽

Closed Head

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Traumatic Axonal Injury after Closed Head Injury in the Neonatal Pig

Journal of Neurotrauma ◽

10.1089/08977150260190438 ◽

2002 ◽

Vol 19 (7) ◽

pp. 843-853 ◽

Cited By ~ 98

Author(s):

Ramesh Raghupathi ◽

Susan S. Margulies

Keyword(s):

Head Injury ◽

Axonal Injury ◽

Closed Head Injury ◽

Traumatic Axonal Injury ◽

Closed Head ◽

Neonatal Pig

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Demonstration of massive traumatic brain swelling within 20 minutes after injury

Journal of Neurosurgery ◽

10.3171/jns.1977.46.2.0256 ◽

1977 ◽

Vol 46 (2) ◽

pp. 256-258 ◽

Cited By ~ 40

Author(s):

Arthur I. Kobrine ◽

Eugene Timmins ◽

Rodwan K. Rajjoub ◽

Hugo V. Rizzoli ◽

David O. Davis

Keyword(s):

Head Injury ◽

Closed Head Injury ◽

Brain Swelling ◽

Axial Tomography ◽

Content Type ◽

Closed Head ◽

Vascular Dilatation ◽

Computerized Axial Tomography ◽

The Brain ◽

Fine Print

✓ The authors documented by computerized axial tomography a case of massive brain swelling occurring within 20 minutes of a closed head injury. It is suggested that the cause of the brain swelling is acute vascular dilatation.

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