Magnetic resonance imaging evidence of progression of subacute brain atrophy in moderate to severe traumatic brain injury.

Abstract:

OBJECTIVE:To demonstrate subacute progression of brain atrophy (from 4.5-29mo postinjury) in moderate to severe traumatic brain injury (TBI) using structural magnetic resonance imaging (MRI). DESIGN:Within-subjects, repeated-measures design. SETTING:Inpatient neurorehabilitation program and teaching hospital (MRI department). PARTICIPANTS:Adults (N=14) with moderate to severe TBI. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:Neuroradiologist readings and volumetric measurements (total brain cerebrospinal fluid and hippocampus) at 4.5 months and 2.5 years postinjury. RESULTS:Ten of 14 patients showed visible atrophy progression. Significant increase in cerebrospinal fluid (CSF) volume (t(13)=-4.073, P<.001) and decrease in right and left hippocampal volumes (t(13)=4.221, P<.001 and t(13)=3.078, P<.005, respectively) were observed from 4.5 months to 2.5 years. Compared with published normative data, patients with TBI showed significantly more pathologic percent annual volume change for the hippocampi (t(26)=-3.864, P<.001, right; and t(26)=-2.737, P<.01, left), and a trend for CSF (t(26)=1.655, P=.059). CONCLUSIONS:This study provides strong MRI evidence for subacute progression of atrophy, as distinct from early, acute neurologic changes observed.

journal_name

Arch Phys Med Rehabil

authors

Ng K,Mikulis DJ,Glazer J,Kabani N,Till C,Greenberg G,Thompson A,Lazinski D,Agid R,Colella B,Green RE

doi

10.1016/j.apmr.2008.07.006

subject

Has Abstract

pub_date

2008-12-01 00:00:00

pages

S35-44

issue

12 Suppl

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(08)01406-8

journal_volume

89

pub_type

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