Clinical outcomes of diffuse axonal injury after traumatic brain injury according to magnetic resonance grading

PURPOSE: To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. METHOD: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. RESULTS: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. CONCLUSION: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.

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Genu of corpus callosum in diffuse axonal injury induces a worse 1-year outcome in patients with traumatic brain injury

Acta Neurochirurgica ◽

10.1007/s00701-011-1002-9 ◽

2011 ◽

Vol 153 (8) ◽

pp. 1687-1694 ◽

Cited By ~ 8

Author(s):

Hidetoshi Matsukawa ◽

Masaki Shinoda ◽

Motoharu Fujii ◽

Osamu Takahashi ◽

Daisuke Yamamoto ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Corpus Callosum ◽

Axonal Injury ◽

Diffuse Axonal Injury

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281 Predicting neurodegeneration after traumatic brain injury

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-abn.145 ◽

2018 ◽

Vol 89 (10) ◽

pp. A42.1-A42

Author(s):

Graham Neil SN ◽

Jolly Amy E ◽

Bourke Niall J ◽

Scott Gregory ◽

Cole James H ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

White Matter ◽

Brain Atrophy ◽

Diffusion Tensor ◽

Chronic Traumatic Encephalopathy ◽

Axonal Injury ◽

Diffuse Axonal Injury ◽

Jacobian Determinant ◽

Post Injury

BackgroundDementia rates are elevated after traumatic brain injury (TBI) and a subgroup develops chronic traumatic encephalopathy. Post-traumatic neurodegeneration can be measured by brain atrophy rates derived from neuroimaging, but it is unclear how atrophy relates to the initial pattern of injury.ObjectivesTo investigate the relationship between baseline TBI patterns and subsequent neurodegeneration measured by progressive brain atrophy.Methods55 patients after moderate-severe TBI (mean 3 years post-injury) and 20 controls underwent longitudinal MRI. Brain atrophy was quantified using the Jacobian determinant defined from volumetric T1 scans approximately one year apart. Diffuse axonal injury was measured using diffusion tensor imaging and focal injuries defined from T1 and FLAIR. Neuropsychological assessment was performed.ResultsAbnormal progressive brain atrophy was seen after TBI (~1.8%/year in white matter). This was accompanied by widespread reductions in fractional anisotropy, in keeping with the presence of diffuse axonal injury. There was a strong negative correlation between FA and brain atrophy, whereby areas of greater white matter damage showed greater atrophy over time.ConclusionsThe results show a strong relationship between the location of diffuse axonal injury and subsequent neurodegeneration. This suggests that TBI triggers progressive neurodegeneration through the long-lasting effects of diffuse axonal injury.

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