Diagnostic capabilities of magnetic susceptibility-weighted images in traumatic brain injury in children

Introduction. In MRI, the difference in sensitivity between tissues is used to obtain images weighted by the inhomogeneity of the magnetic field termed susceptibility-weighted imaging (SWI) and a high-resolution 3D radiofrequency gradient echo scan with full speed compensation is applied. The aim was to determine the features of lesions caused by traumatic brain injury in children using the SWI sequence. Materials and methods. 535 TBI children aged two months up to 18 years old (average age 9.58 ± 1.5) were studied. There were 325 boys (60.7%), 210 girls (39.3%). MRI was performed without and with intravenous contrast on a Phillips Achieva 3 T scanner with T1- and T2WI, 2D and 3D images, FLAIR, magnetic resonance angiography (TOF MRA), SWI, and DW/DTI, MRS and fMRI, SWI were used for visualization of DAI. Results. Patients included children with severe TBI - 178 (33.3%), moderate TBI - 172 (32.1%) and mild TBI - 185 (34.6%). Of the 535 injured children, 129 (24.1%) had MRI performed within the first 24 hours from the moment of injury, up to 48 hours - at 91 (17.0%), up to 72 hours - in 78 (14.6%) and up to 13 days - in 237 (44.3%). DAI foci at all degrees of TBI were detected in 422 (78.9%) children out of 535 children. Conclusion. SWI is a sensitive method for diagnosing brain lesions in TBI and significantly contributes to predicting outcomes in the early stages after trauma. The amount of brain lesions diagnosed by SWI correlates with the degree of injury according to the Glasgo Coma Scale. The study of the brain functional connections can inform about possible relationships between the localization of the SWI lesion and cognitive deficits, potentially providing an opportunity to use SWI in the hyperacute phase.

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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Supplemental Material for Heterogeneity of Brain Lesions in Pediatric Traumatic Brain Injury

Neuropsychology ◽

10.1037/a0032837.supp ◽

2013 ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Brain Lesions ◽

Pediatric Traumatic Brain Injury

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Six-year analysis of traumatic injuries of the craniomaxillofacial area: relation between maxillofacial and traumatic brain injuries

SUCHASNA STOMATOLOHIYA ◽

10.33295/1992-576x-2021-1-56 ◽

2021 ◽

Vol 105 (1) ◽

pp. 56-60

Author(s):

E. Shuminsky ◽

◽

A. Kopchak ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Correlation Analysis ◽

Brain Injuries ◽

Statistical Significance ◽

Maxillofacial Trauma ◽

Traumatic Injuries ◽

The Face ◽

The Difference ◽

Panfacial Fractures

Summary. Craniofacial trauma is one of the most difficult types of injuries. There is disagreement among various authors about the relationship between maxillofacial trauma (MFT) and traumatic brain injury (TBI). Purpose. Retrospectively evaluate the epidemiology of traumatic injuries of the craniomaxillofacial area and determine whether there is a relationship between different isolated or combined fractures of the facial bones and brain damage. Materials and methods. The case histories of three groups of patients with isolated fractures of the mandible (I group), isolated fractures of the midface zone (II group) and combined fractures of all areas of the face (III group), who were hospitalized in the period from 2012 to 2017, were analyzed. The main epidemiological indicators were determined. The analysis of indicators of severity of MFT and TBI is carried out. Correlation analysis of indicators, analysis using the Kruskal- Wallis test and Steel-Dwass test for pairwise comparisons was performed. Results. Were treated519 patients. 457 men (88 %) and 62 women (12 %). The main causes of injuries were assaults (40 %). Correlation analysis did not reveal the dependence of MFT and TBI. The difference in severity of isolated fractures of the mandible and midface bones was statistically significant, and there is a statistical significance between the severity of TBI in case of isolated fractures of midface bones and panfacial fractures (p < 0.05). Conclusions. The severity of maxillofacial trauma in the case of panfacial fractures is on average 3 times higher than in the case of isolated fractures of the lower jaw or midface bones. The severity of TBI is largely consistent with concussion in all groups, but in the group with panfacial fractures, the median rate is lower comparing to other groups. Key words: Glasgow coma scale, fracture, Le Fort, traumatic brain injury

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Multi-Modal Magnetic Resonance Imaging in the Acute and Sub-Acute Phase of Mild Traumatic Brain Injury: Can We See the Difference?

Journal of Neurotrauma ◽

10.1089/neu.2012.2486 ◽

2013 ◽

Vol 30 (1) ◽

pp. 2-10 ◽

Cited By ~ 70

Author(s):

Arnold Toth ◽

Noemi Kovacs ◽

Gabor Perlaki ◽

Gergely Orsi ◽

Mihaly Aradi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Magnetic Resonance ◽

Mild Traumatic Brain Injury ◽

Acute Phase ◽

Resonance Imaging ◽

The Difference

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Prognostic Significance of the Difference Between Mixed and Jugular Venous Oxygen Saturation After Severe Traumatic Brain Injury: A Post Hoc Analysis of the Brain Hypothermia Study

World Neurosurgery ◽

10.1016/j.wneu.2020.01.004 ◽

2020 ◽

Vol 137 ◽

pp. e68-e74

Author(s):

Naofumi Bunya ◽

Wakiko Aisaka ◽

Kei Miyata ◽

Eichi Narimatsu ◽

Susumu Yamashita ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Oxygen Saturation ◽

Severe Traumatic Brain Injury ◽

Prognostic Significance ◽

Post Hoc Analysis ◽

Venous Oxygen Saturation ◽

The Difference ◽

Post Hoc ◽

The Brain

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Neurological Disorders of Attention

10.1093/oxfordhb/9780199675111.013.027 ◽

2014 ◽

Author(s):

Sanjay Manohar ◽

Valerie Bonnelle ◽

Masud Husain

Keyword(s):

Parkinson’S Disease ◽

Traumatic Brain Injury ◽

Parkinson's Disease ◽

Brain Injury ◽

Neurological Disorders ◽

Brain Regions ◽

Brain Lesions ◽

Attention Deficits ◽

Higher Cognitive Functions ◽

Real Challenge

Attention deficits are a frequent and particularly disabling consequence of many neurological disorders, from patients with focal brain lesions through to individuals with traumatic brain injury or neurodegenerative conditions, such as Parkinson’s disease. They are often associated with apparent confusion, fatigue, irritability, and increased time and effort to perform even simple everyday tasks, and constitute a real challenge for rehabilitation. In many cases, attention deficits may be crucial factors underlying failures of memory and higher cognitive functions, contributing to difficulties in resuming previous activities and independent daily living. Here the authors first consider four aspects of attention—selective, sustained, executive, and divided—together with brain regions and networks considered to underpin normal attention and disorders of attention. The authors focus on focal brain lesions, traumatic brain injury and Parkinson’s disease as important examples illustrating the effects of different brain pathologies on attention function.

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Cocaine Abuse, Traumatic Brain Injury, and Preexisting Brain Lesions as Risk Factors for Bupropion-Associated Psychosis

Journal of Clinical Psychopharmacology ◽

10.1097/jcp.0000000000000729 ◽

2017 ◽

Vol 37 (4) ◽

pp. 459-463 ◽

Cited By ~ 2

Author(s):

Rajdip Barman ◽

Sanjeev Kumar ◽

Bhuvaneshwar Pagadala ◽

Mark B. Detweiler

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Cocaine Abuse ◽

Brain Lesions

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The preventive effect of dexmedetomidine on paroxysmal sympathetic hyperactivity in severe traumatic brain injury patients who have undergone surgery: a retrospective study

PeerJ ◽

10.7717/peerj.2986 ◽

2017 ◽

Vol 5 ◽

pp. e2986 ◽

Cited By ~ 8

Author(s):

Qilin Tang ◽

Xiang Wu ◽

Weiji Weng ◽

Hongpeng Li ◽

Junfeng Feng ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Control Group ◽

Therapeutic Effects ◽

Preventive Effect ◽

Sympathetic Hyperactivity ◽

Paroxysmal Sympathetic Hyperactivity ◽

Hospital Stays ◽

The Difference

BackgroundParoxysmal sympathetic hyperactivity (PSH) results and aggravates in secondary brain injury, which seriously affects the prognosis of severe traumatic brain injury patients. Although several studies have focused on the treatment of PSH, few have concentrated on its prevention.MethodsNinety post-operation (post-op) severe traumatic brain injury (sTBI) patients admitted from October 2014 to April 2016 were chosen to participate in this study. Fifty of the post-op sTBI patients were sedated with dexmedetomidine and were referred as the “dexmedetomidine group” (admitted from May 2015 to April 2016). The other 40 patients (admitted from October 2014 to May 2015) received other sedations and were referred as the “control group.” The two groups were then compared based on their PSH scores and the scores and ratios of those patients who met the criteria of “probable,” “possible” and “unlikely” using the PSH assessment measure (PSH-AM) designed by Baguley et al. (2014). The durations of the neurosurgery intensive care unit (NICU) and hospital stays and the Glasgow outcome scale (GOS) values for the two groups were also compared to evaluate the therapeutic effects and the patients’ prognosis.ResultsThe overall PSH score for the dexmedetomidine group was 5.26 ± 4.66, compared with 8.58 ± 8.09 for the control group. The difference between the two groups’ PSH scores was significant (P = 0.017). The score of the patients who met the criterion of “probable” was 18.33 ± 1.53 in the dexmedetomidine group and 22.63 ± 2.97 in the control group, and the difference was statistically significant (P = 0.045). The ratio of patients who were classified as “unlikely” between the two groups was statistically significant (P = 0.028); that is, 42 (84%) in the dexmedetomidine group and 25 (62.5%) in the control group. The differences in NICU, hospital stays and GOS values between the two groups were not significant.ConclusionDexmedetomidine has a preventive effect on PSH in sTBI patients who have undergone surgery.

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A-103 Examining Self-Awareness in Acute Stroke and Traumatic Brain Injury Populations

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.121 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1152-1152

Author(s):

Vanessa Watorek ◽

Susan Shwartz ◽

Chelsea Day

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Acute Stroke ◽

Left Hemisphere ◽

Acquired Brain Injury ◽

Self Awareness ◽

Review Of The Literature ◽

Level Of Education ◽

Patient Awareness ◽

The Difference

Abstract Objective Following acquired brain injury (ABI), self-awareness of deficits is frequently diminished. A review of the literature suggests most investigations of self-awareness following ABI have been in traumatic brain injury (TBI) populations, with emerging research in those with stroke (e.g., Al Banna et al., 2016). Therefore, this study examined self-awareness across diagnoses, neuroanatomical correlates, and demographics. Method Participants included 82 patients (TBI n = 59 and stroke n = 23) from an inpatient ABI unit. Patients, neuropsychologists, and family members completed the Awareness Questionnaire (AQ). The difference between patient-clinician or patient-family total score was examined, with scores >20 suggestive of impaired self-awareness. Results Participants with left-hemisphere (LH) injury endorsed higher functioning (Patient Total) compared to those with right or bilateral injury, p 0.05. However, there was greater difference scores between those with TBI compared to stroke on patient-clinician total cognitive scores t(80) = 2.125, p = 0.037 and patient-family behavioral/affective total scores t(15.86) = 4.045, p < 0.001 such that those with TBI’s were more aware of their deficits. Regarding demographics, level of education predicted level of patient awareness, but no demographic factors predicted the overall difference score. Conclusions Individuals with LH injury may be more prone to reduced awareness than expected. Additionally, specific domains of functioning may be more useful in examining awareness deficits across diagnostic groups than overall scores.

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