Brain pathology after mild traumatic brain injury: an exploratory study by repeated magnetic resonance examination.

Abstract

OBJECTIVE:

To explore brain pathology after mild traumatic brain injury by repeated magnetic resonance examination.

DESIGN:

A prospective follow-up study.

SUBJECTS:

Nineteen patients with mild traumatic brain injury presenting with Glasgow Coma Scale (GCS) 14-15.

METHODS:

The patients were examined on day 2 or 3 and 3-7 months after the injury. The magnetic resonance protocol comprised conventional T1- and T2-weighted sequences including fluid attenuated inversion recovery (FLAIR), two susceptibility-weighted sequences to reveal haemorrhages, and diffusion-weighted sequences. Computer-aided volume comparison was performed. Clinical outcome was assessed by the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Hospital Anxiety and Depression Scale (HADS) and Glasgow Outcome Scale Extended (GOSE).

RESULTS:

At follow-up, 7 patients (37%) reported ≥  3 symptoms in RPQ, 5 reported some anxiety and 1 reported mild depression. Fifteen patients reported upper level of good recovery and 4 patients lower level of good recovery (GOSE 8 and 7, respectively). Magnetic resonance pathology was found in 1 patient at the first examination, but 4 patients (21%) showed volume loss at the second examination, at which 3 of them reported < 3 symptoms and 1 ≥ 3 symptoms, all exhibiting GOSE scores of 8.

CONCLUSION:

Loss of brain volume, demonstrated by computer-aided magnetic resonance imaging volumetry, may be a feasible marker of brain pathology after mild traumatic brain injury.

• Authors: Marianne Lannsjö, Raili Raininko, Mariana Bustamante, Charlotta von Seth, Jörgen Borg
• Journal: Journal of rehabilitation medicine (J Rehabil Med) Vol. 45 Issue 8 Pg. 721-8 (Sep 2013) ISSN: 1651-2081 [Electronic] Sweden
• PMID: 24002306 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Brain (pathology)
• Brain Injuries (diagnosis, pathology)
• Female
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Organ Size
• Prospective Studies
• Young Adult