Adam, O; Mac Donald, C L; Rivet, D; Ritter, J; May, T; Barefield, M; Duckworth, J; LaBarge, D; Asher, D; Drinkwine, B; Woods, Y; Connor, M; Brody, D L
Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan Journal Article
In: Neurology, vol. 85, pp. 219–227, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Adam2015,
title = {Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan},
author = {Adam, O and {Mac Donald}, C L and Rivet, D and Ritter, J and May, T and Barefield, M and Duckworth, J and LaBarge, D and Asher, D and Drinkwine, B and Woods, Y and Connor, M and Brody, D L},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {219--227},
address = {Adam,Octavian. From the Division of Neurology (O.A.) and Departments of Neurological Surgery (D.R.) and Radiology (D.L.), Naval Medical Center Portsmouth, VA; Department of Neurology (C.L.M., D.L.B.), Washington University, St. Louis, MO; Department of Ne},
abstract = {OBJECTIVE: To evaluate whether diffusion tensor imaging (DTI) will noninvasively reveal white matter changes not present on conventional MRI in acute blast-related mild traumatic brain injury (mTBI) and to determine correlations with clinical measures and recovery. METHODS: Prospective observational study of 95 US military service members with mTBI enrolled within 7 days from injury in Afghanistan and 101 healthy controls. Assessments included Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ), Post-Traumatic Stress Disorder Checklist Military (PCLM), Beck Depression Inventory (BDI), Balance Error Scoring System (BESS), Automated Neuropsychological Assessment Metrics (ANAM), conventional MRI, and DTI. RESULTS: Significantly greater impairment was observed in participants with mTBI vs controls: RPCSQ (19.7 +/- 12.9 vs 3.6 +/- 7.1, p \< 0.001), PCLM (32 +/- 13.2 vs 20.9 +/- 7.1, p \< 0.001), BDI (7.4 +/- 6.8 vs 2.5 +/- 4.9, p \< 0.001), and BESS (18.2 +/- 8.4 vs 15.1 +/- 8.3},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Tsao, J W
Comment: Does brain DTI MRI aid diagnosis of battlefield concussion? Journal Article
In: Neurology, vol. 85, pp. 226, 2015.
BibTeX | Tags: Imaging & EEG
@article{Tsao2015,
title = {Comment: Does brain DTI MRI aid diagnosis of battlefield concussion?},
author = {Tsao, J W},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {226},
address = {Tsao,Jack W. From the US Navy Bureau of Medicine and Surgery, Falls Church, VA; and Uniformed Services University of the Health Sciences, Bethesda, MD.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Wylie, G R; Freeman, K; Thomas, A; Shpaner, M; M, O Keefe; Watts, R; Naylor, M R
Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period Journal Article
In: PLoS ONE, vol. 10, pp. e0126110, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Wylie2015,
title = {Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period},
author = {Wylie, G R and Freeman, K and Thomas, A and Shpaner, M and M, O Keefe and Watts, R and Naylor, M R},
year = {2015},
date = {2015-01-01},
journal = {PLoS ONE},
volume = {10},
pages = {e0126110},
address = {Wylie,Glenn R. Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States of America; Department of Physical Medicine and Rehabilitation, Rutgers University Medical School, Newark, NJ, United States of America; War Related Illn},
abstract = {Functional neuroimaging studies in mild traumatic brain injury (mTBI) have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns \< 72 hours after mild traumatic brain injury (mTBI) and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed \< 72 hours after injury, with most patients showing clinical recovery (i.e., improvement in these measures) within 1 week after the initial assessment. We also hypothesized that increased memory workload at 1 week following injury would expose different cortical activation patterns in mTBI patients with persistent post-concussive symptoms, compared to those with full clinical recovery. We performed a prospective, cohort study of working memory in emergency department patients with isolated head injury and clinical diagnosis of concussion, compared to control subjects (both uninjured volunteers and emergency department patients with extremity injuries and no head trauma). The primary outcome of cognitive recovery was defined as resolution of reported cognitive impairment and quantified by scoring the subject's reported cognitive post-concussive symptoms at 1 week. Secondary outcomes included additional post-concussive symptoms and neurocognitive testing results. We enrolled 46 subjects: 27 with mild TBI and 19 controls. The time of initial neuroimaging was 48 (+22 S.D.) hours after injury (time 1). At follow up (8.7, + 1.2 S.D., days after injury, time 2), 18 of mTBI subjects (64%) reported moderate to complete cognitive recovery, 8 of whom fully recovered between initial and follow-up imaging. fMRI changes from time 1 to time 2 showed an increase in posterior cingulate activation in the mTBI subjects compared to controls. Increases in activation were greater in those mTBI subjects without cognitive recovery. As workload increased in mTBI subjects, activation increased in cortical regions in the right hemisphere. In summary, we found neuroimaging evidence for working memory deficits during the first week following mild traumatic brain injury. Subjects with persistent cognitive symptoms after mTBI had increased requirement for posterior cingulate activation to complete memory tasks at 1 week following a brain injury. These results provide insight into functional activation patterns during initial recovery from mTBI and expose the regional activation networks that may be involved in working memory deficits.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Womack, K B; Didehbani, N; Spence, J S; Conover, H; Hart Jr., J; Kraut, M A; Cullum, C M
Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes Journal Article
In: JAMA Neurology, vol. 72, pp. 773–780, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Strain2015,
title = {Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes},
author = {Strain, J F and Womack, K B and Didehbani, N and Spence, J S and Conover, H and {Hart Jr.}, J and Kraut, M A and Cullum, C M},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
pages = {773--780},
address = {Strain,Jeremy F. Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas. Womack,Kyle B. Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas3Department of Neurology and Neuro},
abstract = {IMPORTANCE: To our knowledge, this is the first study to show an association between concussion, cognition, and anatomical structural brain changes across the age spectrum in former National Football League athletes. OBJECTIVE: To assess the relationship of hippocampal volume, memory performance, and the influence of concussion history in retired National Football League athletes with and without mild cognitive impairment (MCI). DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study assessed differences between groups, mean hippocampal volumes, and memory performance by computing age quintiles based on group-specific linear regression models corrected for multiple comparisons for both athletes and control participants. The study was conducted starting in November 2010 and is ongoing at a research center in the northern region of Texas. This current analysis was conducted from October 9, 2013, to August 21, 2014. Participants included 28 retired National Football League athletes, 8 of whom had MCI and a history of concussion, 21 cognitively healthy control participants, and 6 control participants with MCI without concussion. MAIN OUTCOMES AND MEASURES: Hippocampal volume, age, California Verbal Learning Test scores, and the number of grade 3 (G3) concussions. In addition, the number of games played was examined as an objective variable pertaining to football history. RESULTS: The mean (SD) age was 58.1 (13) years for the 28 former athletes and 59.0 (12) years for the 27 control participants. Retired athletes with concussion history but without cognitive impairment had normal but significantly lower California Verbal Learning Test scores compared with control participants (mean [SD], 52.5 [8] vs 60.24 [7]; P=.002); those with a concussion history and MCI performed worse (mean [SD], 37 [8.62]) compared with both control participants (P\<.001) and athletes without memory impairment (P\<.001). Among the athletes, 17 had a G3 concussion and 11 did not. Older retired athletes with at least 1 G3 concussion had significantly smaller bilateral hippocampal volumes compared with control participants at the 40th age percentile (left},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Maruta, J
Ocular disconjugacy cannot be measured without establishing a solid spatial reference Journal Article
In: F1000Research, vol. 4, pp. 71, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Maruta2015,
title = {Ocular disconjugacy cannot be measured without establishing a solid spatial reference},
author = {Maruta, J},
year = {2015},
date = {2015-01-01},
journal = {F1000Research},
volume = {4},
pages = {71},
address = {Maruta,Jun. Brain Trauma Foundation, One Broadway, 6th Floor, New York, NY 10007, USA.},
abstract = {This correspondence points out a need for clarification concerning the methodology utilized in the study "Eye tracking detects disconjugate eye movements associated with structural traumatic brain injury and concussion", recently published in Journal of Neurotrauma. The authors of the paper state that binocular eye movements were recorded using a single-camera video-oculography technique and that binocular disconjugate characteristics were analyzed without calibration of eye orientation. It is claimed that a variance-based disconjugacy metric was found to be sensitive to the severity of a concussive brain injury and to the status of recovery after the original injury. However, the reproducibility of the paper's findings may be challenged simply by the paucity of details in the methodological description. More importantly, from the information supplied or cited in the paper, it is difficult to evaluate the validity of the potentially interesting conclusions of the paper.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Mechtler, L L; Shastri, K K; Crutchfield, K E
Advanced neuroimaging of mild traumatic brain injury Journal Article
In: Neurologic Clinics, vol. 32, pp. 31–58, 2014.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Mechtler2014,
title = {Advanced neuroimaging of mild traumatic brain injury},
author = {Mechtler, L L and Shastri, K K and Crutchfield, K E},
year = {2014},
date = {2014-01-01},
journal = {Neurologic Clinics},
volume = {32},
pages = {31--58},
address = {Department of Neurology and Neuro-Oncology, State University of New York at Buffalo, 3435 Main Street, Buffalo, NY 14223, USA; Dent Neurologic Institute, 3980A Sheridan Drive, Suite 101, Amherst, NY 14226, USA. Electronic address: lmechtler@dentinstitute.},
abstract = {This article focuses on advancements in neuroimaging techniques, compares the advantages of each of the modalities in the evaluation of mild traumatic brain injury, and discusses their contribution to our understanding of the pathophysiology as it relates to prognosis. Advanced neuroimaging techniques discussed include anatomic/structural imaging techniques, such as diffusion tensor imaging and susceptibility-weighted imaging, and functional imaging techniques, such as functional magnetic resonance imaging, perfusion-weighted imaging, magnetic resonance spectroscopy, and positron emission tomography.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Smith, K
Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury Journal Article
In: Nature Reviews Neurology, vol. 8, pp. 474, 2012.
BibTeX | Tags: Imaging & EEG
@article{Smith2012,
title = {Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury},
author = {Smith, K},
year = {2012},
date = {2012-01-01},
journal = {Nature Reviews Neurology},
volume = {8},
pages = {474},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Slobounov, S; Gay, M; Johnson, B; Zhang, K
Concussion in athletics: ongoing clinical and brain imaging research controversies Journal Article
In: Brain Imaging and Behavior, vol. 6, pp. 224–243, 2012.
Abstract | Links | BibTeX | Tags: Imaging & EEG
@article{Slobounov2012,
title = {Concussion in athletics: ongoing clinical and brain imaging research controversies},
author = {Slobounov, S and Gay, M and Johnson, B and Zhang, K},
doi = {10.1007/s11682-012-9167-2},
year = {2012},
date = {2012-01-01},
journal = {Brain Imaging and Behavior},
volume = {6},
pages = {224--243},
abstract = {Concussion, the most common form of traumatic brain injury, proves to be increasingly complex and not mild in nature as its synonymous term mild traumatic brain injury (mTBI) would imply. Despite the increasing occurrence and prevalence of mTBI there is no universally accepted definition and conventional brain imaging techniques lack the sensitivity to detect subtle changes it causes. Moreover, clinical management of sports induced mild traumatic brain injury has not changed much over the past decade. Advances in neuroimaging that include electroencephalography (EEG), functional magnetic resonance imaging (fMRI), resting-state functional connectivity, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) offer promise in aiding research into understanding the complexities and nuances of mTBI which may ultimately influence clinical management of the condition. In this paper the authors review the major findings from these advanced neuroimaging methods along with current controversy within this field of research. As mTBI is frequently associated with youth and sports injury this review focuses on sportsaEurorelated mTBI in the younger population.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Krishna, Ranga; Grinn, Michael; Giordano, Nicholas; Thirunavukkarasu, Magesh; Tadi, Prasanna; Das, Shibani
Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report Journal Article
In: Journal of Medical Case Reports, vol. 6, pp. 66, 2012.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Krishna2012,
title = {Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report},
author = {Krishna, Ranga and Grinn, Michael and Giordano, Nicholas and Thirunavukkarasu, Magesh and Tadi, Prasanna and Das, Shibani},
year = {2012},
date = {2012-01-01},
journal = {Journal of Medical Case Reports},
volume = {6},
pages = {66},
address = {Medical Clinic of New York, 1513 Voorhies Avenue, Brooklyn, New York 11235, USA. rkrishna@pol.net.},
abstract = {UNLABELLED: ABSTRACT: INTRODUCTION: Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. CASE PRESENTATION: This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. CONCLUSION: Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Keefer, Raina
In the game Journal Article
In: ACR Bulletin, vol. 67, no. 10, pp. 10–12, 2012, ISBN: 0098-6070.
BibTeX | Tags: Athletes, Brain -- Pathology, Brain Concussion -- Classification, Brain Concussion -- Complications, Brain Concussion -- Epidemiology -- United States, Brain Concussion -- Pathology, Brain Injuries -- Diagnosis, DIAGNOSTIC imaging, football, FOOTBALL injuries, Imaging & EEG, Physiopathology, Radiologists, Severity of Injury
@article{Keefer2012,
title = {In the game},
author = {Keefer, Raina},
isbn = {0098-6070},
year = {2012},
date = {2012-01-01},
journal = {ACR Bulletin},
volume = {67},
number = {10},
pages = {10--12},
keywords = {Athletes, Brain -- Pathology, Brain Concussion -- Classification, Brain Concussion -- Complications, Brain Concussion -- Epidemiology -- United States, Brain Concussion -- Pathology, Brain Injuries -- Diagnosis, DIAGNOSTIC imaging, football, FOOTBALL injuries, Imaging \& EEG, Physiopathology, Radiologists, Severity of Injury},
pubstate = {published},
tppubtype = {article}
}
Gonzalez, Peter G; Walker, Matthew T
Imaging modalities in mild traumatic brain injury and sports concussion Journal Article
In: PM & R, vol. 3, pp. S413–24, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Gonzalez2011,
title = {Imaging modalities in mild traumatic brain injury and sports concussion},
author = {Gonzalez, Peter G and Walker, Matthew T},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S413--24},
address = {Department of Physical Medicine and Rehabilitation, Eastern Virginia Medical School, 721 Fairfax Ave, 3rd Floor, Norfolk VA, 23507(+).},
abstract = {Mild traumatic brain injury is a significant public health issue that has been gaining considerable attention over the past few years. After injury, a large percentage of patients experience postconcussive symptoms that affect work and school performance and that carry significant medicolegal implications. Conventional imaging modalities (computed tomography and magnetic resonance imaging) are insensitive to microstructural changes and underestimate the degree of diffuse axonal injury and metabolic changes. Newer imaging techniques have attempted to better diagnose and characterize diffuse axonal injury and the metabolic and functional aspects of traumatic brain injury. The following review article summarizes the currently available imaging studies and describes the novel and more investigational techniques available for mild traumatic brain injury. A suggested algorithm is offered.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Pulsipher, Dalin T; Campbell, Richard A; Thoma, Robert; King, John H
A critical review of neuroimaging applications in sports concussion Journal Article
In: Current Sports Medicine Reports, vol. 10, pp. 14–20, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Pulsipher2011,
title = {A critical review of neuroimaging applications in sports concussion},
author = {Pulsipher, Dalin T and Campbell, Richard A and Thoma, Robert and King, John H},
year = {2011},
date = {2011-01-01},
journal = {Current Sports Medicine Reports},
volume = {10},
pages = {14--20},
address = {Department of Psychiatry, University of New Mexico Health Sciences Center, Center for Neuropsychological Services, University of New Mexico, Albuquerque, NM 87131-0001, USA. dalin.pulsipher@my.rfums.org},
abstract = {While abnormalities related to concussion are typically not identified on traditional clinical neuroimaging (i.e., computed tomography [CT] or magnetic resonance imaging [MRI]), more sophisticated neuroimaging techniques have the potential to reveal the complex neurometabolic processes related to concussion and its recovery. Clinically, these techniques may one day provide useful information to guide clinicians in the management and treatment of sports concussion. This article critically reviews the current state of the literature regarding neuroimaging and sports concussion, identifies challenges in the application of these techniques, and identifies areas for future research.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Gosselin, N; Bottari, C; Chen, J K; Petrides, M; Tinawi, S; de Guise, E; Ptito, A
Electrophysiology and functional MRI in post-acute mild traumatic brain injury Journal Article
In: Journal of Neurotrauma, vol. 28, pp. 329–341, 2011, ISSN: 0897-7151.
Abstract | Links | BibTeX | Tags: Imaging & EEG
@article{Gosselin2011,
title = {Electrophysiology and functional MRI in post-acute mild traumatic brain injury},
author = {Gosselin, N and Bottari, C and Chen, J K and Petrides, M and Tinawi, S and de Guise, E and Ptito, A},
doi = {10.1089/neu.2010.1493},
issn = {0897-7151},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neurotrauma},
volume = {28},
pages = {329--341},
abstract = {Symptoms persisting beyond the acute phase (\>2 months) after a mild traumatic brain injury (MTBI) are often reported, but their origin remains controversial. Some investigators evoke dysfunctional cerebral mechanisms, while others ascribe them to the psychological consequences of the injury. We address this controversy by exploring possible cerebral dysfunction with functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) in a group of patients during the post-acute phase. Fourteen MTBI symptomatic patients (5.7 +/- 2.9 months post-injury) were tested with fMRI and ERP using a visual externally ordered working memory task, and were compared with 23 control subjects. Attenuated blood oxygen level dependent (BOLD) signal changes in the left and right mid-dorsolateral prefrontal cortex (mid-DLPFC), the putamen, the body of the caudate nucleus, and the right thalamus were found in the MTBI group compared with the control group. Moreover, symptom severity and BOLD signal changes were correlated: patients with more severe symptoms had lower BOLD signal changes in the right mid-DLPFC. For ERP, a group x task interaction was observed for N350 amplitude. A larger amplitude for the working memory task than for the control task was found in control subjects, but not in MTBI subjects, who had weak amplitudes for both tasks. This study confirms that persistent symptoms after MTBI cannot be uniquely explained by psychological factors, such as depression and/or malingering, and indicates that they can be associated with cerebral dysfunction. ERP reveals decreased amplitude of the N350 component, while fMRI demonstrates that the more severe the symptoms, the lower the BOLD signal changes in the mid-DLPFC.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Prabhu, Sanjay P
The role of neuroimaging in sport-related concussion Journal Article
In: Clinics in Sports Medicine, vol. 30, pp. 103–114, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Prabhu2011,
title = {The role of neuroimaging in sport-related concussion},
author = {Prabhu, Sanjay P},
year = {2011},
date = {2011-01-01},
journal = {Clinics in Sports Medicine},
volume = {30},
pages = {103--114},
address = {Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. sanjay.prabhu@childrens.harvard.edu},
abstract = {This article describes some of the newer techniques that are being used in the clinical assessment of patients following mild to moderate TBI, addresses their use in the acute setting, and explores their potential role in long-term follow-up. Also addressed are the challenges faced before some of these newer techniques can be incorporated into routine clinical management. Large studies are needed with a special emphasis on the effects of repeated head trauma in the young athlete. This is especially relevant where conventional imaging does not demonstrate a macroscopic abnormality. The emphasis has to shift from identifying structural abnormalities on imaging studies to understanding the functional changes in the brain that may explain the long-term neuropsychological effects of concussion and mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Grossman, Elan J; Inglese, Matilde; Bammer, Roland
Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine? Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 21, pp. 379–386, 2010.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Grossman2010,
title = {Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine?},
author = {Grossman, Elan J and Inglese, Matilde and Bammer, Roland},
year = {2010},
date = {2010-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {21},
pages = {379--386},
address = {Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, NY, USA.},
abstract = {ABSTRACT: Mild traumatic brain injury (MTBI) is difficult to accurately assess with conventional imaging because such approaches usually fail to detect any evidence of brain damage. Recent studies of MTBI patients using diffusion-weighted imaging and diffusion tensor imaging suggest that these techniques have the potential to help grade tissue damage severity, track its development, and provide prognostic markers for clinical outcome. Although these results are promising and indicate that the forensic diagnosis of MTBI might eventually benefit from the use of diffusion-weighted imaging and diffusion tensor imaging, healthy skepticism and caution should be exercised with regard to interpreting their meaning because there is no consensus about which methods of data analysis to use and very few investigations have been conducted, of which most have been small in sample size and examined patients at only one time point after injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Rabb, C H
Comments Journal Article
In: Neurosurgery, vol. 67, no. 4, pp. 1027–1028, 2010, ISBN: 0148-396X.
BibTeX | Tags: brain concussion, functional magnetic resonance imaging, human, Imaging & EEG, mental task, neuroimaging, Note, priority journal, sport injury, working memory Overviews
@article{Rabb2010,
title = {Comments},
author = {Rabb, C H},
isbn = {0148-396X},
year = {2010},
date = {2010-01-01},
journal = {Neurosurgery},
volume = {67},
number = {4},
pages = {1027--1028},
keywords = {brain concussion, functional magnetic resonance imaging, human, Imaging \& EEG, mental task, neuroimaging, Note, priority journal, sport injury, working memory Overviews},
pubstate = {published},
tppubtype = {article}
}
Jacobs, Bram; Beems, Tjemme; Stulemeijer, Maja; van Vugt, Arie B; van der Vliet, Ton M; Borm, George F; Vos, Pieter E
Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities Journal Article
In: Journal of Neurotrauma, vol. 27, pp. 655–668, 2010.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Jacobs2010,
title = {Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities},
author = {Jacobs, Bram and Beems, Tjemme and Stulemeijer, Maja and van Vugt, Arie B and van der Vliet, Ton M and Borm, George F and Vos, Pieter E},
year = {2010},
date = {2010-01-01},
journal = {Journal of Neurotrauma},
volume = {27},
pages = {655--668},
address = {Department of Neurology, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands.},
abstract = {Mild traumatic brain injury (mTBI) is a common heterogeneous neurological disorder with a wide range of possible clinical outcomes. Accurate prediction of outcome is desirable for optimal treatment. This study aimed both to identify the demographic, clinical, and computed tomographic (CT) characteristics associated with unfavorable outcome at 6 months after mTBI, and to design a prediction model for application in daily practice. All consecutive mTBI patients (Glasgow Coma Scale [GCS] score: 13-15) admitted to our hospital who were age 16 or older were included during an 8-year period as part of the prospective Radboud University Brain Injury Cohort Study (RUBICS). Outcome was assessed at 6 months post-trauma using the Glasgow Outcome Scale-Extended (GOSE), dichotomized into unfavorable (GOSE score 1-6) and favorable (GOSE score 7-8) outcome groups. The predictive value of several variables was determined using multivariate binary logistic regression analysis. We included 2784 mTBI patients and found CT abnormalities in 20.7% of the 1999 patients that underwent a head CT. Age, extracranial injuries, and day-of-injury alcohol intoxication proved to be the strongest outcome predictors. The presence of facial fractures and the number of hemorrhagic contusions emerged as CT predictors. Furthermore, we showed that the predictive value of a scheme based on a modified Injury Severity Score (ISS), alcohol intoxication, and age equalled the value of one that also included CT characteristics. In fact, it exceeded one that was based on CT characteristics alone. We conclude that, although valuable for the identification of the individual mTBI patient at risk for deterioration and eventual neurosurgical intervention, CT characteristics are imperfect predictors of outcome after mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Schrader, Harald; Mickeviciene, Dalia; Gleizniene, Rymante; Jakstiene, Silvija; Surkiene, Danguole; Stovner, Lars Jacob; Obelieniene, Diana
Magnetic resonance imaging after most common form of concussion Journal Article
In: BMC Medical Imaging, vol. 9, pp. 11, 2009.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Schrader2009,
title = {Magnetic resonance imaging after most common form of concussion},
author = {Schrader, Harald and Mickeviciene, Dalia and Gleizniene, Rymante and Jakstiene, Silvija and Surkiene, Danguole and Stovner, Lars Jacob and Obelieniene, Diana},
year = {2009},
date = {2009-01-01},
journal = {BMC Medical Imaging},
volume = {9},
pages = {11},
address = {Department of Neurology and Clinical Neurophysiology, Trondheim University Hospital, 7006 Trondheim, Norway. harald.schrader@ntnu.no},
abstract = {BACKGROUND: Until now there is a lack of carefully controlled studies with conventional MR imaging performed exclusively in concussion with short lasting loss of consciousness (LOC). METHODS: A MR investigation was performed within 24 hours and after 3 months in 20 patients who had suffered a concussion with a verified loss of consciousness of maximally 5 minutes. As a control group, 20 age- and gender matched patients with minor orthopaedic injuries had a MR investigation using the same protocol. RESULTS: In a concussion population with an average LOC duration of 1. 4 minutes no case with unequivocal intracranial traumatic pathology was detected. CONCLUSION: An ordinary concussion with short lasting LOC does not or only seldom result in a degree of diffuse axonal injury (DAI) that is visualized by conventional MR with field strength of 1.0 Tesla (T). Analysis of earlier MR studies in concussion using field strength of 1.5 T as well as of studies with diffusion tensor MR imaging (MR DTI) reveal methodological shortcomings, in particular use of inadequate control groups. There is, therefore, a need for carefully controlled studies using MR of higher field strength and/or studies with MR DTI exclusively in common concussion with LOC of maximally 5 minutes.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Ono, Kenichiro; Wada, Kojiro; Takahara, Takashi; Shirotani, Toshiki
Indications for computed tomography in patients with mild head injury Journal Article
In: Neurologia Medico-Chirurgica, vol. 47, pp. 291–298, 2007.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Ono2007,
title = {Indications for computed tomography in patients with mild head injury},
author = {Ono, Kenichiro and Wada, Kojiro and Takahara, Takashi and Shirotani, Toshiki},
year = {2007},
date = {2007-01-01},
journal = {Neurologia Medico-Chirurgica},
volume = {47},
pages = {291--298},
address = {Department of Neurosurgery, Japan Self Defense Forces Central Hospital, Tokyo.},
abstract = {The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46 +/- 23 years), with mild head injury (Glasgow Coma Scale [GCS] score \> or =14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r = 0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age \> or =60 years, male sex, JCS score \> or =1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score \>0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age \> or =60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n = 21) or patient request (n = 17). These indications for CT including JCS may be useful in the management of patients with mild head injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Cohen, B A; Inglese, M; Rusinek, H; Babb, J S; Grossman, R I; Gonen, O
Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury Journal Article
In: AJNR: American Journal of Neuroradiology, vol. 28, pp. 907–913, 2007.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Cohen2007,
title = {Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury},
author = {Cohen, B A and Inglese, M and Rusinek, H and Babb, J S and Grossman, R I and Gonen, O},
year = {2007},
date = {2007-01-01},
journal = {AJNR: American Journal of Neuroradiology},
volume = {28},
pages = {907--913},
address = {Department of Radiology, New York University School of Medicine, New York, NY 10016, USA. oded.gonen@med.nyu.edu},
abstract = {BACKGROUND AND PURPOSE: More than 85% of brain traumas are classified as "mild"; MR imaging findings are minimal if any and do not correspond to clinical symptoms. Our goal, therefore, was to quantify the global decline of the neuronal marker N-acetylaspartate (NAA), as well as gray (GM) and white matter (WM) atrophy after mild traumatic brain injury (mTBI). MATERIALS AND METHODS: Twenty patients (11 male, 9 female; age range, 19-57 years; median, 35 years) with mTBI (Glasgow Coma Scale score 13-15 with loss of consciousness for at least 30 seconds) and 19 age- and sex-matched control subjects were studied. Seven patients were studied within 9 days of TBI; the other 13 ranged from 1.2 months to 31.5 years (average and median of 4.6 and 1.7 years, respectively) after injury. Whole-brain NAA (WBNAA) concentration was obtained in all subjects with nonlocalizing proton MR spectroscopy. Brain volume and GM and WM fractions were segmented from T1-weighted MR imaging and normalized to the total intracranial volume, suitable for intersubject comparisons. The data were analyzed with least squares regression. RESULTS: Patients with mTBI exhibited, on average, a 12% WBNAA deficit that increased with age, compared with the control subjects (p\<.05). Adjusted for age effects, patients also suffered both global atrophy (-1.09%/year; P=.029) and GM atrophy (-0.89%/year; P=.042). Patients with and without visible MR imaging pathology, typically punctate foci of suspected shearing injury, were indistinguishable in both atrophy and WBNAA. CONCLUSION: WBNAA detected neuronal/axonal injury beyond the minimal focal MR-visible lesions in mTBI. Combined with GM atrophy, the findings may provide further, noninvasive insight into the nature and progression of mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Gowda, N K; Agrawal, D; Bal, C; Chandrashekar, N; Tripati, M; Bandopadhyaya, G P; Malhotra, A; Mahapatra, A K
Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study Journal Article
In: AJNR: American Journal of Neuroradiology, vol. 27, pp. 447–451, 2006.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Gowda2006,
title = {Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study},
author = {Gowda, N K and Agrawal, D and Bal, C and Chandrashekar, N and Tripati, M and Bandopadhyaya, G P and Malhotra, A and Mahapatra, A K},
year = {2006},
date = {2006-01-01},
journal = {AJNR: American Journal of Neuroradiology},
volume = {27},
pages = {447--451},
address = {Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi.},
abstract = {PURPOSE: To explore the role of single-photon emission CT (SPECT) in initial diagnostic evaluation of patients with mild traumatic brain injury (MTBI) and to identify subgroups in which it may serve as a useful diagnostic tool. MATERIALS AND METHODS: Patients with MTBI seen during a 14-month period were prospectively included in this study. All patients had a CT of head within 12 hours of injury and SPECT by using technetium Tc99m ethyl cysteinate dimer (Tc99m-ECD) within 72 hours of injury. Both SPECT and CT findings were compared with clinical features such as posttraumatic amnesia (PTA), postconcussion syndrome (PCS), and loss of consciousness (LOC). RESULTS: Ninety-two patients with MTBI underwent SPECT in the study period. There were 28 children and 64 adults, with male-to-female ratio of 4.5 to 1. CT findings were abnormal in 31 (34%) and SPECT in 58 (63%). The most common abnormality was hypoperfusion in the frontal lobe(s) in adults and the temporal lobe in children. A significantly higher number of perfusion abnormalities were seen in patients with PTA (P = .03), LOC (P = .02), and PCS (P = .01) than in patients without these symptoms. Compared to CT, SPECT had a much higher sensitivity for detecting an organic basis in these subgroup, of patients (P \< .05). CONCLUSION: Tc99m-ECD SPECT can be used as a complementary technique to CT in initial evaluation of patients with MTBI. It is particularly useful in patients having PCS, LOC, or PTA with normal CT scan.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Abu-Judeh, H H; Parker, R; Aleksic, S; Singh, M L; Naddaf, S; Atay, S; Kumar, M; Omar, W; El-Zeftawy, H; Luo, J Q; Abdel-Dayem, H M
SPECT brain perfusion findings in mild or moderate traumatic brain injury Journal Article
In: Nuclear Medicine Review, vol. 3, pp. 5–11, 2000.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Abu-Judeh2000,
title = {SPECT brain perfusion findings in mild or moderate traumatic brain injury},
author = {Abu-Judeh, H H and Parker, R and Aleksic, S and Singh, M L and Naddaf, S and Atay, S and Kumar, M and Omar, W and El-Zeftawy, H and Luo, J Q and Abdel-Dayem, H M},
year = {2000},
date = {2000-01-01},
journal = {Nuclear Medicine Review},
volume = {3},
pages = {5--11},
address = {Abu-Judeh,H H. Department of Neurology, NYU Medical Center, New York, New York, USA.},
abstract = {BACKGROUND: The purpose of this manuscript is to present the findings in the largest series of SPECT brain perfusion imaging reported to date for mild or moderate traumatic brain injury. PATIENTS AND METHODS: This is a retrospective evaluation of 228 SPECT brain perfusion-imaging studies of patients who suffered mild or moderate traumatic brain injury with or without loss of consciousness (LOC). All patients had no past medical history of previous brain trauma, neurological, or psychiatric diseases, HIV, alcohol or drug abuse. The patient population included 135 males and 93 females. The ages ranged from 11-88 years (mean 40.8). The most common complaints were characteristic of the postconcussion syndrome: headaches 139/228 (61%); dizziness 61/228 (27%); and memory problems 63/228 (28%). LOC status was reported to be positive in 121/228 (53%), negative in 41/228 (18%), and unknown for 63/228 (28%). RESULTS: Normal studies accounted for 52/228 (23%). For abnormal studies (176/228 or 77%) the findings were as follows: basal ganglia hypoperfusion 338 lesions (55.2%); frontal lobe hypoperfusion 146 (23.8%); temporal lobes hypoperfusion 80 (13%); parietal lobes hypoperfusion 20 (3.7%); insular and or occipital lobes hypoperfusion 28 (4.6%). Patients' symptoms correlated with the SPECT brain perfusion findings. The SPECT BPI studies in 122/228 (54%) were done early within 3 months of the date of the accident, and for the remainder, 106/228 (46%) over 3 months and less than 3 years from the date of the injury. In early imaging, 382 lesions were detected; in 92 patients (average 4.2 lesions per study) imaging after 3 months detected 230 lesions: in 84 patients (average 2.7 lesions per study). CONCLUSIONS: Basal ganglia hypoperfusion is the most common abnormality following mild or moderate traumatic brain injury (p = 0.006), and is more common in patients complaining of memory problem (p = 0.0005) and dizziness (p = 0.003). Early imaging can detect more lesions than delayed imaging (p = 0.0011). SPECT brain perfusion abnormalities can occur in the absence of LOC.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L; Lovell, M R; Smith, S; Franzen, M D
Prevalence of abnormal CT-scans following mild head injury Journal Article
In: Brain Injury, vol. 14, pp. 1057–1061, 2000.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Iverson2000,
title = {Prevalence of abnormal CT-scans following mild head injury},
author = {Iverson, G L and Lovell, M R and Smith, S and Franzen, M D},
year = {2000},
date = {2000-01-01},
journal = {Brain Injury},
volume = {14},
pages = {1057--1061},
address = {University of British Columbia, Vancouver, Canada. giverson@interchange.ubc.ca},
abstract = {PRIMARY OBJECTIVE: The purpose of this study was to examine the prevalence of day-of-injury intracranial abnormalities in a large sample of patients with mild head injuries who were admitted to a Trauma Service. METHODS AND PROCEDURES: There were 912 patients who obtained admission Glasgow Coma Scale (GCS) scores of 13-15. MAIN OUTCOMES AND RESULTS: The base rate of complicated mild head injuries (i.e. abnormal CT scans) in this sample was 15.8%. However, nearly 25% of the sample, most of whom had very mild injuries, did not receive CT-scans. Therefore, the actual prevalence is more likely in the range 16-21%. There was a tremendous overlap in injury characteristics between patients with complicated and uncomplicated mild head injuries. None the less, there were modest, yet statistically significant, relationships between the presence of intracranial abnormalities and lower GCS scores, greater frequency of positive loss of consciousness, greater frequency of skull fractures, and lower GOAT scores.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Freed, S; Hellerstein, L F
Visual electrodiagnostic findings in mild traumatic brain injury Journal Article
In: Brain Injury, vol. 11, pp. 25–36, 1997.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Freed1997,
title = {Visual electrodiagnostic findings in mild traumatic brain injury},
author = {Freed, S and Hellerstein, L F},
year = {1997},
date = {1997-01-01},
journal = {Brain Injury},
volume = {11},
pages = {25--36},
address = {Colorado Eye Center/Ophthalmology, Physiology Laboratory, Denver, USA.},
abstract = {Patients with traumatic brain injury (TBI) frequently exhibit varied forms of visual system dysfunction including: binocular, oculomotor, accommodative, refractive error shift, visual field loss, and visual perceptual deficits. A 5-year collaborative study between optometry and ophthalmology was initiated to follow documented mild TBI patients utilizing diagnostic methods to assess the quantity and quality of visual system deficits and recovery. A group of patients with mild TBI receiving optometric rehabilitation were compared with a group of age-matched, gender-matched, and headsize-matched TBI patients not receiving such treatment. Eighteen patients diagnosed with mild TBI underwent a treatment regimen of optometric rehabilitation (group I); 32 patients diagnosed with mild TBI did not receive optometric rehabilitation (group II). Pattern visually evoked cortical potential (VECP) testing and electroretinography (ERG) evaluation were utilized initially, repeated 6-12 months later and then 12-18 months after baseline. All TBI patients' VECP and ERG results were compared to age-matched, headsize-matched controls. Once the ERG had been used to exclude retinal involvement, identification of visual pathway dysfunction was possible with the VECP. Full-field ERG results in all groups were not remarkable and not sensitive for patients with mild TBI. Initial testing results revealed that 72% of those TBI patients in group I demonstrated VECP waveform abnormalities and 81% of those patients in group II showed waveform dysfunction. In the testing performed 12-18 months later, 38% of group I TBI patients, after receiving a treatment regimen of optometric rehabilitation, showed VECP waveform abnormalities; 78% of group II TBI patients demonstrated waveform abnormalities. VECP evaluation in patients with mild TBI can provide a useful and reliable tool for objective assessment of visual system deficit and recovery. Significant differences in visual system recovery were shown when comparing group I and group II.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Parkinson, D
Evaluating cerebral concussion Journal Article
In: Surgical Neurology, vol. 45, pp. 459–462, 1996.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Parkinson1996,
title = {Evaluating cerebral concussion},
author = {Parkinson, D},
year = {1996},
date = {1996-01-01},
journal = {Surgical Neurology},
volume = {45},
pages = {459--462},
address = {Department of Anatomy, University of Manitoba, Winnipeg, Canada.},
abstract = {Years ago we developed a rat model that was consistently comatose for 1-2 seconds following 50 G acceleration of the head. Motor normalcy returned in about 10 seconds, and normal memory in an hour. There were immediate electroencephalogram and transmitter changes. All these returned to normal within an hour following 1 or 20 such concussions. We could find no light or electron microscopic changes. Halothane anesthesia precludes measurement of coma and introduces distortion of metabolite findings. To date our findings indicated concussion at this level is completely reversible.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Murshid, W R
Role of skull radiography in the initial evaluation of minor head injury: a retrospective study Journal Article
In: Acta Neurochirurgica, vol. 129, pp. 11–14, 1994.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Murshid1994,
title = {Role of skull radiography in the initial evaluation of minor head injury: a retrospective study},
author = {Murshid, W R},
year = {1994},
date = {1994-01-01},
journal = {Acta Neurochirurgica},
volume = {129},
pages = {11--14},
address = {Department of Surgery, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia.},
abstract = {The use of skull radiography in the initial evaluation of minor head injured patients is controversial. In an attempt to evaluate its benefits, a retrospective study of 566 cases subjected to skull radiography following close minor head trauma (Glasgow Coma Scale 13-15), is presented. A skull fracture (linear vault, depressed or base of skull) was present in 64 (11%) cases. Only three (5%) who were found to have a skull fracture on skull radiography developed an intracranial injury which required surgery. Intracranial injuries developed in 19 (3%) cases and were followed by surgery in six (32%). All, except for one case, had a decreased level of consciousness and a Glasgow Coma Scale less than 15, few had focal neurological deficits. Management had not been altered by the results of skull radiography in any of the cases. We concluded that skull radiographs are unnecessary for the decision process in closed minor head injury because management decisions are based primarily on a careful neurological examination. When intracranial injuries are a concern, a CT scan should be obtained.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Servadei, F
Is skull X-ray necessary after milder head trauma? Journal Article
In: British Journal of Neurosurgery, vol. 6, pp. 167–168, 1992.
BibTeX | Tags: Imaging & EEG
@article{Servadei1992,
title = {Is skull X-ray necessary after milder head trauma?},
author = {Servadei, F},
year = {1992},
date = {1992-01-01},
journal = {British Journal of Neurosurgery},
volume = {6},
pages = {167--168},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Snow, R B; Zimmerman, R D; Gandy, S E; Deck, M D
Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury Journal Article
In: Neurosurgery, vol. 18, pp. 45–52, 1986.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Snow1986,
title = {Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury},
author = {Snow, R B and Zimmerman, R D and Gandy, S E and Deck, M D},
year = {1986},
date = {1986-01-01},
journal = {Neurosurgery},
volume = {18},
pages = {45--52},
abstract = {Thirty-five patients who had incurred head trauma were studied with computed tomography (CT) and magnetic resonance imaging (MRI). CT was performed using a General Electric 8800 scanner. MRI was conducted with a Technicare Teslacon system using a 5.0 kG (0.5 T) magnetic field. Clinically, patients varied from those with mild concussions without focal neurological signs to those with severe neurological dysfunction including posttraumatic coma. MRI was superior to CT in imaging 23 of 41 extracerebral fluid collections, both in estimating the size of the collections and in diagnosing small collections. MRI was also superior to CT in distinguishing chronic subdural hematomas from hygromas. Further, MRI was superior to CT in visualizing nonhemorrhagic contusion in 15 of 21 lesions. Because of the potential failure of MRI to diagnose acute subarachnoid or acute parenchymal hemorrhage, CT remains the procedure of choice in diagnosing head injury less than 72 hours old.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Sekino, H; Nakamura, N; Yuki, K; Satoh, J; Kikuchi, K; Sanada, S
Brain lesions detected by CT scans in cases of minor head injuries Journal Article
In: Neurologia Medico-Chirurgica, vol. 21, pp. 677–683, 1981.
BibTeX | Tags: Imaging & EEG
@article{Sekino1981,
title = {Brain lesions detected by CT scans in cases of minor head injuries},
author = {Sekino, H and Nakamura, N and Yuki, K and Satoh, J and Kikuchi, K and Sanada, S},
year = {1981},
date = {1981-01-01},
journal = {Neurologia Medico-Chirurgica},
volume = {21},
pages = {677--683},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Adam, O; Mac Donald, C L; Rivet, D; Ritter, J; May, T; Barefield, M; Duckworth, J; LaBarge, D; Asher, D; Drinkwine, B; Woods, Y; Connor, M; Brody, D L
Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan Journal Article
In: Neurology, vol. 85, pp. 219–227, 2015.
@article{Adam2015,
title = {Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan},
author = {Adam, O and {Mac Donald}, C L and Rivet, D and Ritter, J and May, T and Barefield, M and Duckworth, J and LaBarge, D and Asher, D and Drinkwine, B and Woods, Y and Connor, M and Brody, D L},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {219--227},
address = {Adam,Octavian. From the Division of Neurology (O.A.) and Departments of Neurological Surgery (D.R.) and Radiology (D.L.), Naval Medical Center Portsmouth, VA; Department of Neurology (C.L.M., D.L.B.), Washington University, St. Louis, MO; Department of Ne},
abstract = {OBJECTIVE: To evaluate whether diffusion tensor imaging (DTI) will noninvasively reveal white matter changes not present on conventional MRI in acute blast-related mild traumatic brain injury (mTBI) and to determine correlations with clinical measures and recovery. METHODS: Prospective observational study of 95 US military service members with mTBI enrolled within 7 days from injury in Afghanistan and 101 healthy controls. Assessments included Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ), Post-Traumatic Stress Disorder Checklist Military (PCLM), Beck Depression Inventory (BDI), Balance Error Scoring System (BESS), Automated Neuropsychological Assessment Metrics (ANAM), conventional MRI, and DTI. RESULTS: Significantly greater impairment was observed in participants with mTBI vs controls: RPCSQ (19.7 +/- 12.9 vs 3.6 +/- 7.1, p \< 0.001), PCLM (32 +/- 13.2 vs 20.9 +/- 7.1, p \< 0.001), BDI (7.4 +/- 6.8 vs 2.5 +/- 4.9, p \< 0.001), and BESS (18.2 +/- 8.4 vs 15.1 +/- 8.3},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Tsao, J W
Comment: Does brain DTI MRI aid diagnosis of battlefield concussion? Journal Article
In: Neurology, vol. 85, pp. 226, 2015.
@article{Tsao2015,
title = {Comment: Does brain DTI MRI aid diagnosis of battlefield concussion?},
author = {Tsao, J W},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {226},
address = {Tsao,Jack W. From the US Navy Bureau of Medicine and Surgery, Falls Church, VA; and Uniformed Services University of the Health Sciences, Bethesda, MD.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Wylie, G R; Freeman, K; Thomas, A; Shpaner, M; M, O Keefe; Watts, R; Naylor, M R
Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period Journal Article
In: PLoS ONE, vol. 10, pp. e0126110, 2015.
@article{Wylie2015,
title = {Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period},
author = {Wylie, G R and Freeman, K and Thomas, A and Shpaner, M and M, O Keefe and Watts, R and Naylor, M R},
year = {2015},
date = {2015-01-01},
journal = {PLoS ONE},
volume = {10},
pages = {e0126110},
address = {Wylie,Glenn R. Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States of America; Department of Physical Medicine and Rehabilitation, Rutgers University Medical School, Newark, NJ, United States of America; War Related Illn},
abstract = {Functional neuroimaging studies in mild traumatic brain injury (mTBI) have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns \< 72 hours after mild traumatic brain injury (mTBI) and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed \< 72 hours after injury, with most patients showing clinical recovery (i.e., improvement in these measures) within 1 week after the initial assessment. We also hypothesized that increased memory workload at 1 week following injury would expose different cortical activation patterns in mTBI patients with persistent post-concussive symptoms, compared to those with full clinical recovery. We performed a prospective, cohort study of working memory in emergency department patients with isolated head injury and clinical diagnosis of concussion, compared to control subjects (both uninjured volunteers and emergency department patients with extremity injuries and no head trauma). The primary outcome of cognitive recovery was defined as resolution of reported cognitive impairment and quantified by scoring the subject's reported cognitive post-concussive symptoms at 1 week. Secondary outcomes included additional post-concussive symptoms and neurocognitive testing results. We enrolled 46 subjects: 27 with mild TBI and 19 controls. The time of initial neuroimaging was 48 (+22 S.D.) hours after injury (time 1). At follow up (8.7, + 1.2 S.D., days after injury, time 2), 18 of mTBI subjects (64%) reported moderate to complete cognitive recovery, 8 of whom fully recovered between initial and follow-up imaging. fMRI changes from time 1 to time 2 showed an increase in posterior cingulate activation in the mTBI subjects compared to controls. Increases in activation were greater in those mTBI subjects without cognitive recovery. As workload increased in mTBI subjects, activation increased in cortical regions in the right hemisphere. In summary, we found neuroimaging evidence for working memory deficits during the first week following mild traumatic brain injury. Subjects with persistent cognitive symptoms after mTBI had increased requirement for posterior cingulate activation to complete memory tasks at 1 week following a brain injury. These results provide insight into functional activation patterns during initial recovery from mTBI and expose the regional activation networks that may be involved in working memory deficits.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Womack, K B; Didehbani, N; Spence, J S; Conover, H; Hart Jr., J; Kraut, M A; Cullum, C M
Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes Journal Article
In: JAMA Neurology, vol. 72, pp. 773–780, 2015.
@article{Strain2015,
title = {Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes},
author = {Strain, J F and Womack, K B and Didehbani, N and Spence, J S and Conover, H and {Hart Jr.}, J and Kraut, M A and Cullum, C M},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
pages = {773--780},
address = {Strain,Jeremy F. Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas. Womack,Kyle B. Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas3Department of Neurology and Neuro},
abstract = {IMPORTANCE: To our knowledge, this is the first study to show an association between concussion, cognition, and anatomical structural brain changes across the age spectrum in former National Football League athletes. OBJECTIVE: To assess the relationship of hippocampal volume, memory performance, and the influence of concussion history in retired National Football League athletes with and without mild cognitive impairment (MCI). DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study assessed differences between groups, mean hippocampal volumes, and memory performance by computing age quintiles based on group-specific linear regression models corrected for multiple comparisons for both athletes and control participants. The study was conducted starting in November 2010 and is ongoing at a research center in the northern region of Texas. This current analysis was conducted from October 9, 2013, to August 21, 2014. Participants included 28 retired National Football League athletes, 8 of whom had MCI and a history of concussion, 21 cognitively healthy control participants, and 6 control participants with MCI without concussion. MAIN OUTCOMES AND MEASURES: Hippocampal volume, age, California Verbal Learning Test scores, and the number of grade 3 (G3) concussions. In addition, the number of games played was examined as an objective variable pertaining to football history. RESULTS: The mean (SD) age was 58.1 (13) years for the 28 former athletes and 59.0 (12) years for the 27 control participants. Retired athletes with concussion history but without cognitive impairment had normal but significantly lower California Verbal Learning Test scores compared with control participants (mean [SD], 52.5 [8] vs 60.24 [7]; P=.002); those with a concussion history and MCI performed worse (mean [SD], 37 [8.62]) compared with both control participants (P\<.001) and athletes without memory impairment (P\<.001). Among the athletes, 17 had a G3 concussion and 11 did not. Older retired athletes with at least 1 G3 concussion had significantly smaller bilateral hippocampal volumes compared with control participants at the 40th age percentile (left},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Maruta, J
Ocular disconjugacy cannot be measured without establishing a solid spatial reference Journal Article
In: F1000Research, vol. 4, pp. 71, 2015.
@article{Maruta2015,
title = {Ocular disconjugacy cannot be measured without establishing a solid spatial reference},
author = {Maruta, J},
year = {2015},
date = {2015-01-01},
journal = {F1000Research},
volume = {4},
pages = {71},
address = {Maruta,Jun. Brain Trauma Foundation, One Broadway, 6th Floor, New York, NY 10007, USA.},
abstract = {This correspondence points out a need for clarification concerning the methodology utilized in the study "Eye tracking detects disconjugate eye movements associated with structural traumatic brain injury and concussion", recently published in Journal of Neurotrauma. The authors of the paper state that binocular eye movements were recorded using a single-camera video-oculography technique and that binocular disconjugate characteristics were analyzed without calibration of eye orientation. It is claimed that a variance-based disconjugacy metric was found to be sensitive to the severity of a concussive brain injury and to the status of recovery after the original injury. However, the reproducibility of the paper's findings may be challenged simply by the paucity of details in the methodological description. More importantly, from the information supplied or cited in the paper, it is difficult to evaluate the validity of the potentially interesting conclusions of the paper.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Mechtler, L L; Shastri, K K; Crutchfield, K E
Advanced neuroimaging of mild traumatic brain injury Journal Article
In: Neurologic Clinics, vol. 32, pp. 31–58, 2014.
@article{Mechtler2014,
title = {Advanced neuroimaging of mild traumatic brain injury},
author = {Mechtler, L L and Shastri, K K and Crutchfield, K E},
year = {2014},
date = {2014-01-01},
journal = {Neurologic Clinics},
volume = {32},
pages = {31--58},
address = {Department of Neurology and Neuro-Oncology, State University of New York at Buffalo, 3435 Main Street, Buffalo, NY 14223, USA; Dent Neurologic Institute, 3980A Sheridan Drive, Suite 101, Amherst, NY 14226, USA. Electronic address: lmechtler@dentinstitute.},
abstract = {This article focuses on advancements in neuroimaging techniques, compares the advantages of each of the modalities in the evaluation of mild traumatic brain injury, and discusses their contribution to our understanding of the pathophysiology as it relates to prognosis. Advanced neuroimaging techniques discussed include anatomic/structural imaging techniques, such as diffusion tensor imaging and susceptibility-weighted imaging, and functional imaging techniques, such as functional magnetic resonance imaging, perfusion-weighted imaging, magnetic resonance spectroscopy, and positron emission tomography.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Smith, K
Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury Journal Article
In: Nature Reviews Neurology, vol. 8, pp. 474, 2012.
@article{Smith2012,
title = {Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury},
author = {Smith, K},
year = {2012},
date = {2012-01-01},
journal = {Nature Reviews Neurology},
volume = {8},
pages = {474},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Slobounov, S; Gay, M; Johnson, B; Zhang, K
Concussion in athletics: ongoing clinical and brain imaging research controversies Journal Article
In: Brain Imaging and Behavior, vol. 6, pp. 224–243, 2012.
@article{Slobounov2012,
title = {Concussion in athletics: ongoing clinical and brain imaging research controversies},
author = {Slobounov, S and Gay, M and Johnson, B and Zhang, K},
doi = {10.1007/s11682-012-9167-2},
year = {2012},
date = {2012-01-01},
journal = {Brain Imaging and Behavior},
volume = {6},
pages = {224--243},
abstract = {Concussion, the most common form of traumatic brain injury, proves to be increasingly complex and not mild in nature as its synonymous term mild traumatic brain injury (mTBI) would imply. Despite the increasing occurrence and prevalence of mTBI there is no universally accepted definition and conventional brain imaging techniques lack the sensitivity to detect subtle changes it causes. Moreover, clinical management of sports induced mild traumatic brain injury has not changed much over the past decade. Advances in neuroimaging that include electroencephalography (EEG), functional magnetic resonance imaging (fMRI), resting-state functional connectivity, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) offer promise in aiding research into understanding the complexities and nuances of mTBI which may ultimately influence clinical management of the condition. In this paper the authors review the major findings from these advanced neuroimaging methods along with current controversy within this field of research. As mTBI is frequently associated with youth and sports injury this review focuses on sportsaEurorelated mTBI in the younger population.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Krishna, Ranga; Grinn, Michael; Giordano, Nicholas; Thirunavukkarasu, Magesh; Tadi, Prasanna; Das, Shibani
Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report Journal Article
In: Journal of Medical Case Reports, vol. 6, pp. 66, 2012.
@article{Krishna2012,
title = {Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report},
author = {Krishna, Ranga and Grinn, Michael and Giordano, Nicholas and Thirunavukkarasu, Magesh and Tadi, Prasanna and Das, Shibani},
year = {2012},
date = {2012-01-01},
journal = {Journal of Medical Case Reports},
volume = {6},
pages = {66},
address = {Medical Clinic of New York, 1513 Voorhies Avenue, Brooklyn, New York 11235, USA. rkrishna@pol.net.},
abstract = {UNLABELLED: ABSTRACT: INTRODUCTION: Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. CASE PRESENTATION: This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. CONCLUSION: Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Keefer, Raina
In the game Journal Article
In: ACR Bulletin, vol. 67, no. 10, pp. 10–12, 2012, ISBN: 0098-6070.
@article{Keefer2012,
title = {In the game},
author = {Keefer, Raina},
isbn = {0098-6070},
year = {2012},
date = {2012-01-01},
journal = {ACR Bulletin},
volume = {67},
number = {10},
pages = {10--12},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gonzalez, Peter G; Walker, Matthew T
Imaging modalities in mild traumatic brain injury and sports concussion Journal Article
In: PM & R, vol. 3, pp. S413–24, 2011.
@article{Gonzalez2011,
title = {Imaging modalities in mild traumatic brain injury and sports concussion},
author = {Gonzalez, Peter G and Walker, Matthew T},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S413--24},
address = {Department of Physical Medicine and Rehabilitation, Eastern Virginia Medical School, 721 Fairfax Ave, 3rd Floor, Norfolk VA, 23507(+).},
abstract = {Mild traumatic brain injury is a significant public health issue that has been gaining considerable attention over the past few years. After injury, a large percentage of patients experience postconcussive symptoms that affect work and school performance and that carry significant medicolegal implications. Conventional imaging modalities (computed tomography and magnetic resonance imaging) are insensitive to microstructural changes and underestimate the degree of diffuse axonal injury and metabolic changes. Newer imaging techniques have attempted to better diagnose and characterize diffuse axonal injury and the metabolic and functional aspects of traumatic brain injury. The following review article summarizes the currently available imaging studies and describes the novel and more investigational techniques available for mild traumatic brain injury. A suggested algorithm is offered.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Pulsipher, Dalin T; Campbell, Richard A; Thoma, Robert; King, John H
A critical review of neuroimaging applications in sports concussion Journal Article
In: Current Sports Medicine Reports, vol. 10, pp. 14–20, 2011.
@article{Pulsipher2011,
title = {A critical review of neuroimaging applications in sports concussion},
author = {Pulsipher, Dalin T and Campbell, Richard A and Thoma, Robert and King, John H},
year = {2011},
date = {2011-01-01},
journal = {Current Sports Medicine Reports},
volume = {10},
pages = {14--20},
address = {Department of Psychiatry, University of New Mexico Health Sciences Center, Center for Neuropsychological Services, University of New Mexico, Albuquerque, NM 87131-0001, USA. dalin.pulsipher@my.rfums.org},
abstract = {While abnormalities related to concussion are typically not identified on traditional clinical neuroimaging (i.e., computed tomography [CT] or magnetic resonance imaging [MRI]), more sophisticated neuroimaging techniques have the potential to reveal the complex neurometabolic processes related to concussion and its recovery. Clinically, these techniques may one day provide useful information to guide clinicians in the management and treatment of sports concussion. This article critically reviews the current state of the literature regarding neuroimaging and sports concussion, identifies challenges in the application of these techniques, and identifies areas for future research.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Gosselin, N; Bottari, C; Chen, J K; Petrides, M; Tinawi, S; de Guise, E; Ptito, A
Electrophysiology and functional MRI in post-acute mild traumatic brain injury Journal Article
In: Journal of Neurotrauma, vol. 28, pp. 329–341, 2011, ISSN: 0897-7151.
@article{Gosselin2011,
title = {Electrophysiology and functional MRI in post-acute mild traumatic brain injury},
author = {Gosselin, N and Bottari, C and Chen, J K and Petrides, M and Tinawi, S and de Guise, E and Ptito, A},
doi = {10.1089/neu.2010.1493},
issn = {0897-7151},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neurotrauma},
volume = {28},
pages = {329--341},
abstract = {Symptoms persisting beyond the acute phase (\>2 months) after a mild traumatic brain injury (MTBI) are often reported, but their origin remains controversial. Some investigators evoke dysfunctional cerebral mechanisms, while others ascribe them to the psychological consequences of the injury. We address this controversy by exploring possible cerebral dysfunction with functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) in a group of patients during the post-acute phase. Fourteen MTBI symptomatic patients (5.7 +/- 2.9 months post-injury) were tested with fMRI and ERP using a visual externally ordered working memory task, and were compared with 23 control subjects. Attenuated blood oxygen level dependent (BOLD) signal changes in the left and right mid-dorsolateral prefrontal cortex (mid-DLPFC), the putamen, the body of the caudate nucleus, and the right thalamus were found in the MTBI group compared with the control group. Moreover, symptom severity and BOLD signal changes were correlated: patients with more severe symptoms had lower BOLD signal changes in the right mid-DLPFC. For ERP, a group x task interaction was observed for N350 amplitude. A larger amplitude for the working memory task than for the control task was found in control subjects, but not in MTBI subjects, who had weak amplitudes for both tasks. This study confirms that persistent symptoms after MTBI cannot be uniquely explained by psychological factors, such as depression and/or malingering, and indicates that they can be associated with cerebral dysfunction. ERP reveals decreased amplitude of the N350 component, while fMRI demonstrates that the more severe the symptoms, the lower the BOLD signal changes in the mid-DLPFC.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Prabhu, Sanjay P
The role of neuroimaging in sport-related concussion Journal Article
In: Clinics in Sports Medicine, vol. 30, pp. 103–114, 2011.
@article{Prabhu2011,
title = {The role of neuroimaging in sport-related concussion},
author = {Prabhu, Sanjay P},
year = {2011},
date = {2011-01-01},
journal = {Clinics in Sports Medicine},
volume = {30},
pages = {103--114},
address = {Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. sanjay.prabhu@childrens.harvard.edu},
abstract = {This article describes some of the newer techniques that are being used in the clinical assessment of patients following mild to moderate TBI, addresses their use in the acute setting, and explores their potential role in long-term follow-up. Also addressed are the challenges faced before some of these newer techniques can be incorporated into routine clinical management. Large studies are needed with a special emphasis on the effects of repeated head trauma in the young athlete. This is especially relevant where conventional imaging does not demonstrate a macroscopic abnormality. The emphasis has to shift from identifying structural abnormalities on imaging studies to understanding the functional changes in the brain that may explain the long-term neuropsychological effects of concussion and mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Grossman, Elan J; Inglese, Matilde; Bammer, Roland
Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine? Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 21, pp. 379–386, 2010.
@article{Grossman2010,
title = {Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine?},
author = {Grossman, Elan J and Inglese, Matilde and Bammer, Roland},
year = {2010},
date = {2010-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {21},
pages = {379--386},
address = {Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, NY, USA.},
abstract = {ABSTRACT: Mild traumatic brain injury (MTBI) is difficult to accurately assess with conventional imaging because such approaches usually fail to detect any evidence of brain damage. Recent studies of MTBI patients using diffusion-weighted imaging and diffusion tensor imaging suggest that these techniques have the potential to help grade tissue damage severity, track its development, and provide prognostic markers for clinical outcome. Although these results are promising and indicate that the forensic diagnosis of MTBI might eventually benefit from the use of diffusion-weighted imaging and diffusion tensor imaging, healthy skepticism and caution should be exercised with regard to interpreting their meaning because there is no consensus about which methods of data analysis to use and very few investigations have been conducted, of which most have been small in sample size and examined patients at only one time point after injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Rabb, C H
Comments Journal Article
In: Neurosurgery, vol. 67, no. 4, pp. 1027–1028, 2010, ISBN: 0148-396X.
@article{Rabb2010,
title = {Comments},
author = {Rabb, C H},
isbn = {0148-396X},
year = {2010},
date = {2010-01-01},
journal = {Neurosurgery},
volume = {67},
number = {4},
pages = {1027--1028},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Jacobs, Bram; Beems, Tjemme; Stulemeijer, Maja; van Vugt, Arie B; van der Vliet, Ton M; Borm, George F; Vos, Pieter E
Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities Journal Article
In: Journal of Neurotrauma, vol. 27, pp. 655–668, 2010.
@article{Jacobs2010,
title = {Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities},
author = {Jacobs, Bram and Beems, Tjemme and Stulemeijer, Maja and van Vugt, Arie B and van der Vliet, Ton M and Borm, George F and Vos, Pieter E},
year = {2010},
date = {2010-01-01},
journal = {Journal of Neurotrauma},
volume = {27},
pages = {655--668},
address = {Department of Neurology, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands.},
abstract = {Mild traumatic brain injury (mTBI) is a common heterogeneous neurological disorder with a wide range of possible clinical outcomes. Accurate prediction of outcome is desirable for optimal treatment. This study aimed both to identify the demographic, clinical, and computed tomographic (CT) characteristics associated with unfavorable outcome at 6 months after mTBI, and to design a prediction model for application in daily practice. All consecutive mTBI patients (Glasgow Coma Scale [GCS] score: 13-15) admitted to our hospital who were age 16 or older were included during an 8-year period as part of the prospective Radboud University Brain Injury Cohort Study (RUBICS). Outcome was assessed at 6 months post-trauma using the Glasgow Outcome Scale-Extended (GOSE), dichotomized into unfavorable (GOSE score 1-6) and favorable (GOSE score 7-8) outcome groups. The predictive value of several variables was determined using multivariate binary logistic regression analysis. We included 2784 mTBI patients and found CT abnormalities in 20.7% of the 1999 patients that underwent a head CT. Age, extracranial injuries, and day-of-injury alcohol intoxication proved to be the strongest outcome predictors. The presence of facial fractures and the number of hemorrhagic contusions emerged as CT predictors. Furthermore, we showed that the predictive value of a scheme based on a modified Injury Severity Score (ISS), alcohol intoxication, and age equalled the value of one that also included CT characteristics. In fact, it exceeded one that was based on CT characteristics alone. We conclude that, although valuable for the identification of the individual mTBI patient at risk for deterioration and eventual neurosurgical intervention, CT characteristics are imperfect predictors of outcome after mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Schrader, Harald; Mickeviciene, Dalia; Gleizniene, Rymante; Jakstiene, Silvija; Surkiene, Danguole; Stovner, Lars Jacob; Obelieniene, Diana
Magnetic resonance imaging after most common form of concussion Journal Article
In: BMC Medical Imaging, vol. 9, pp. 11, 2009.
@article{Schrader2009,
title = {Magnetic resonance imaging after most common form of concussion},
author = {Schrader, Harald and Mickeviciene, Dalia and Gleizniene, Rymante and Jakstiene, Silvija and Surkiene, Danguole and Stovner, Lars Jacob and Obelieniene, Diana},
year = {2009},
date = {2009-01-01},
journal = {BMC Medical Imaging},
volume = {9},
pages = {11},
address = {Department of Neurology and Clinical Neurophysiology, Trondheim University Hospital, 7006 Trondheim, Norway. harald.schrader@ntnu.no},
abstract = {BACKGROUND: Until now there is a lack of carefully controlled studies with conventional MR imaging performed exclusively in concussion with short lasting loss of consciousness (LOC). METHODS: A MR investigation was performed within 24 hours and after 3 months in 20 patients who had suffered a concussion with a verified loss of consciousness of maximally 5 minutes. As a control group, 20 age- and gender matched patients with minor orthopaedic injuries had a MR investigation using the same protocol. RESULTS: In a concussion population with an average LOC duration of 1. 4 minutes no case with unequivocal intracranial traumatic pathology was detected. CONCLUSION: An ordinary concussion with short lasting LOC does not or only seldom result in a degree of diffuse axonal injury (DAI) that is visualized by conventional MR with field strength of 1.0 Tesla (T). Analysis of earlier MR studies in concussion using field strength of 1.5 T as well as of studies with diffusion tensor MR imaging (MR DTI) reveal methodological shortcomings, in particular use of inadequate control groups. There is, therefore, a need for carefully controlled studies using MR of higher field strength and/or studies with MR DTI exclusively in common concussion with LOC of maximally 5 minutes.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ono, Kenichiro; Wada, Kojiro; Takahara, Takashi; Shirotani, Toshiki
Indications for computed tomography in patients with mild head injury Journal Article
In: Neurologia Medico-Chirurgica, vol. 47, pp. 291–298, 2007.
@article{Ono2007,
title = {Indications for computed tomography in patients with mild head injury},
author = {Ono, Kenichiro and Wada, Kojiro and Takahara, Takashi and Shirotani, Toshiki},
year = {2007},
date = {2007-01-01},
journal = {Neurologia Medico-Chirurgica},
volume = {47},
pages = {291--298},
address = {Department of Neurosurgery, Japan Self Defense Forces Central Hospital, Tokyo.},
abstract = {The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46 +/- 23 years), with mild head injury (Glasgow Coma Scale [GCS] score \> or =14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r = 0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age \> or =60 years, male sex, JCS score \> or =1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score \>0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age \> or =60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n = 21) or patient request (n = 17). These indications for CT including JCS may be useful in the management of patients with mild head injury.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cohen, B A; Inglese, M; Rusinek, H; Babb, J S; Grossman, R I; Gonen, O
Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury Journal Article
In: AJNR: American Journal of Neuroradiology, vol. 28, pp. 907–913, 2007.
@article{Cohen2007,
title = {Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury},
author = {Cohen, B A and Inglese, M and Rusinek, H and Babb, J S and Grossman, R I and Gonen, O},
year = {2007},
date = {2007-01-01},
journal = {AJNR: American Journal of Neuroradiology},
volume = {28},
pages = {907--913},
address = {Department of Radiology, New York University School of Medicine, New York, NY 10016, USA. oded.gonen@med.nyu.edu},
abstract = {BACKGROUND AND PURPOSE: More than 85% of brain traumas are classified as "mild"; MR imaging findings are minimal if any and do not correspond to clinical symptoms. Our goal, therefore, was to quantify the global decline of the neuronal marker N-acetylaspartate (NAA), as well as gray (GM) and white matter (WM) atrophy after mild traumatic brain injury (mTBI). MATERIALS AND METHODS: Twenty patients (11 male, 9 female; age range, 19-57 years; median, 35 years) with mTBI (Glasgow Coma Scale score 13-15 with loss of consciousness for at least 30 seconds) and 19 age- and sex-matched control subjects were studied. Seven patients were studied within 9 days of TBI; the other 13 ranged from 1.2 months to 31.5 years (average and median of 4.6 and 1.7 years, respectively) after injury. Whole-brain NAA (WBNAA) concentration was obtained in all subjects with nonlocalizing proton MR spectroscopy. Brain volume and GM and WM fractions were segmented from T1-weighted MR imaging and normalized to the total intracranial volume, suitable for intersubject comparisons. The data were analyzed with least squares regression. RESULTS: Patients with mTBI exhibited, on average, a 12% WBNAA deficit that increased with age, compared with the control subjects (p\<.05). Adjusted for age effects, patients also suffered both global atrophy (-1.09%/year; P=.029) and GM atrophy (-0.89%/year; P=.042). Patients with and without visible MR imaging pathology, typically punctate foci of suspected shearing injury, were indistinguishable in both atrophy and WBNAA. CONCLUSION: WBNAA detected neuronal/axonal injury beyond the minimal focal MR-visible lesions in mTBI. Combined with GM atrophy, the findings may provide further, noninvasive insight into the nature and progression of mTBI.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Adam, O; Mac Donald, C L; Rivet, D; Ritter, J; May, T; Barefield, M; Duckworth, J; LaBarge, D; Asher, D; Drinkwine, B; Woods, Y; Connor, M; Brody, D L
Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan Journal Article
In: Neurology, vol. 85, pp. 219–227, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Adam2015,
title = {Clinical and imaging assessment of acute combat mild traumatic brain injury in Afghanistan},
author = {Adam, O and {Mac Donald}, C L and Rivet, D and Ritter, J and May, T and Barefield, M and Duckworth, J and LaBarge, D and Asher, D and Drinkwine, B and Woods, Y and Connor, M and Brody, D L},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {219--227},
address = {Adam,Octavian. From the Division of Neurology (O.A.) and Departments of Neurological Surgery (D.R.) and Radiology (D.L.), Naval Medical Center Portsmouth, VA; Department of Neurology (C.L.M., D.L.B.), Washington University, St. Louis, MO; Department of Ne},
abstract = {OBJECTIVE: To evaluate whether diffusion tensor imaging (DTI) will noninvasively reveal white matter changes not present on conventional MRI in acute blast-related mild traumatic brain injury (mTBI) and to determine correlations with clinical measures and recovery. METHODS: Prospective observational study of 95 US military service members with mTBI enrolled within 7 days from injury in Afghanistan and 101 healthy controls. Assessments included Rivermead Post-Concussion Symptoms Questionnaire (RPCSQ), Post-Traumatic Stress Disorder Checklist Military (PCLM), Beck Depression Inventory (BDI), Balance Error Scoring System (BESS), Automated Neuropsychological Assessment Metrics (ANAM), conventional MRI, and DTI. RESULTS: Significantly greater impairment was observed in participants with mTBI vs controls: RPCSQ (19.7 +/- 12.9 vs 3.6 +/- 7.1, p \< 0.001), PCLM (32 +/- 13.2 vs 20.9 +/- 7.1, p \< 0.001), BDI (7.4 +/- 6.8 vs 2.5 +/- 4.9, p \< 0.001), and BESS (18.2 +/- 8.4 vs 15.1 +/- 8.3},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Tsao, J W
Comment: Does brain DTI MRI aid diagnosis of battlefield concussion? Journal Article
In: Neurology, vol. 85, pp. 226, 2015.
BibTeX | Tags: Imaging & EEG
@article{Tsao2015,
title = {Comment: Does brain DTI MRI aid diagnosis of battlefield concussion?},
author = {Tsao, J W},
year = {2015},
date = {2015-01-01},
journal = {Neurology},
volume = {85},
pages = {226},
address = {Tsao,Jack W. From the US Navy Bureau of Medicine and Surgery, Falls Church, VA; and Uniformed Services University of the Health Sciences, Bethesda, MD.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Wylie, G R; Freeman, K; Thomas, A; Shpaner, M; M, O Keefe; Watts, R; Naylor, M R
Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period Journal Article
In: PLoS ONE, vol. 10, pp. e0126110, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Wylie2015,
title = {Cognitive Improvement after Mild Traumatic Brain Injury Measured with Functional Neuroimaging during the Acute Period},
author = {Wylie, G R and Freeman, K and Thomas, A and Shpaner, M and M, O Keefe and Watts, R and Naylor, M R},
year = {2015},
date = {2015-01-01},
journal = {PLoS ONE},
volume = {10},
pages = {e0126110},
address = {Wylie,Glenn R. Rocco Ortenzio Neuroimaging Center, Kessler Foundation, West Orange, NJ, United States of America; Department of Physical Medicine and Rehabilitation, Rutgers University Medical School, Newark, NJ, United States of America; War Related Illn},
abstract = {Functional neuroimaging studies in mild traumatic brain injury (mTBI) have been largely limited to patients with persistent post-concussive symptoms, utilizing images obtained months to years after the actual head trauma. We sought to distinguish acute and delayed effects of mild traumatic brain injury on working memory functional brain activation patterns \< 72 hours after mild traumatic brain injury (mTBI) and again one-week later. We hypothesized that clinical and fMRI measures of working memory would be abnormal in symptomatic mTBI patients assessed \< 72 hours after injury, with most patients showing clinical recovery (i.e., improvement in these measures) within 1 week after the initial assessment. We also hypothesized that increased memory workload at 1 week following injury would expose different cortical activation patterns in mTBI patients with persistent post-concussive symptoms, compared to those with full clinical recovery. We performed a prospective, cohort study of working memory in emergency department patients with isolated head injury and clinical diagnosis of concussion, compared to control subjects (both uninjured volunteers and emergency department patients with extremity injuries and no head trauma). The primary outcome of cognitive recovery was defined as resolution of reported cognitive impairment and quantified by scoring the subject's reported cognitive post-concussive symptoms at 1 week. Secondary outcomes included additional post-concussive symptoms and neurocognitive testing results. We enrolled 46 subjects: 27 with mild TBI and 19 controls. The time of initial neuroimaging was 48 (+22 S.D.) hours after injury (time 1). At follow up (8.7, + 1.2 S.D., days after injury, time 2), 18 of mTBI subjects (64%) reported moderate to complete cognitive recovery, 8 of whom fully recovered between initial and follow-up imaging. fMRI changes from time 1 to time 2 showed an increase in posterior cingulate activation in the mTBI subjects compared to controls. Increases in activation were greater in those mTBI subjects without cognitive recovery. As workload increased in mTBI subjects, activation increased in cortical regions in the right hemisphere. In summary, we found neuroimaging evidence for working memory deficits during the first week following mild traumatic brain injury. Subjects with persistent cognitive symptoms after mTBI had increased requirement for posterior cingulate activation to complete memory tasks at 1 week following a brain injury. These results provide insight into functional activation patterns during initial recovery from mTBI and expose the regional activation networks that may be involved in working memory deficits.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Strain, J F; Womack, K B; Didehbani, N; Spence, J S; Conover, H; Hart Jr., J; Kraut, M A; Cullum, C M
Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes Journal Article
In: JAMA Neurology, vol. 72, pp. 773–780, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Strain2015,
title = {Imaging Correlates of Memory and Concussion History in Retired National Football League Athletes},
author = {Strain, J F and Womack, K B and Didehbani, N and Spence, J S and Conover, H and {Hart Jr.}, J and Kraut, M A and Cullum, C M},
year = {2015},
date = {2015-01-01},
journal = {JAMA Neurology},
volume = {72},
pages = {773--780},
address = {Strain,Jeremy F. Center for BrainHealth, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas. Womack,Kyle B. Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas3Department of Neurology and Neuro},
abstract = {IMPORTANCE: To our knowledge, this is the first study to show an association between concussion, cognition, and anatomical structural brain changes across the age spectrum in former National Football League athletes. OBJECTIVE: To assess the relationship of hippocampal volume, memory performance, and the influence of concussion history in retired National Football League athletes with and without mild cognitive impairment (MCI). DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study assessed differences between groups, mean hippocampal volumes, and memory performance by computing age quintiles based on group-specific linear regression models corrected for multiple comparisons for both athletes and control participants. The study was conducted starting in November 2010 and is ongoing at a research center in the northern region of Texas. This current analysis was conducted from October 9, 2013, to August 21, 2014. Participants included 28 retired National Football League athletes, 8 of whom had MCI and a history of concussion, 21 cognitively healthy control participants, and 6 control participants with MCI without concussion. MAIN OUTCOMES AND MEASURES: Hippocampal volume, age, California Verbal Learning Test scores, and the number of grade 3 (G3) concussions. In addition, the number of games played was examined as an objective variable pertaining to football history. RESULTS: The mean (SD) age was 58.1 (13) years for the 28 former athletes and 59.0 (12) years for the 27 control participants. Retired athletes with concussion history but without cognitive impairment had normal but significantly lower California Verbal Learning Test scores compared with control participants (mean [SD], 52.5 [8] vs 60.24 [7]; P=.002); those with a concussion history and MCI performed worse (mean [SD], 37 [8.62]) compared with both control participants (P\<.001) and athletes without memory impairment (P\<.001). Among the athletes, 17 had a G3 concussion and 11 did not. Older retired athletes with at least 1 G3 concussion had significantly smaller bilateral hippocampal volumes compared with control participants at the 40th age percentile (left},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Maruta, J
Ocular disconjugacy cannot be measured without establishing a solid spatial reference Journal Article
In: F1000Research, vol. 4, pp. 71, 2015.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Maruta2015,
title = {Ocular disconjugacy cannot be measured without establishing a solid spatial reference},
author = {Maruta, J},
year = {2015},
date = {2015-01-01},
journal = {F1000Research},
volume = {4},
pages = {71},
address = {Maruta,Jun. Brain Trauma Foundation, One Broadway, 6th Floor, New York, NY 10007, USA.},
abstract = {This correspondence points out a need for clarification concerning the methodology utilized in the study "Eye tracking detects disconjugate eye movements associated with structural traumatic brain injury and concussion", recently published in Journal of Neurotrauma. The authors of the paper state that binocular eye movements were recorded using a single-camera video-oculography technique and that binocular disconjugate characteristics were analyzed without calibration of eye orientation. It is claimed that a variance-based disconjugacy metric was found to be sensitive to the severity of a concussive brain injury and to the status of recovery after the original injury. However, the reproducibility of the paper's findings may be challenged simply by the paucity of details in the methodological description. More importantly, from the information supplied or cited in the paper, it is difficult to evaluate the validity of the potentially interesting conclusions of the paper.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Mechtler, L L; Shastri, K K; Crutchfield, K E
Advanced neuroimaging of mild traumatic brain injury Journal Article
In: Neurologic Clinics, vol. 32, pp. 31–58, 2014.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Mechtler2014,
title = {Advanced neuroimaging of mild traumatic brain injury},
author = {Mechtler, L L and Shastri, K K and Crutchfield, K E},
year = {2014},
date = {2014-01-01},
journal = {Neurologic Clinics},
volume = {32},
pages = {31--58},
address = {Department of Neurology and Neuro-Oncology, State University of New York at Buffalo, 3435 Main Street, Buffalo, NY 14223, USA; Dent Neurologic Institute, 3980A Sheridan Drive, Suite 101, Amherst, NY 14226, USA. Electronic address: lmechtler@dentinstitute.},
abstract = {This article focuses on advancements in neuroimaging techniques, compares the advantages of each of the modalities in the evaluation of mild traumatic brain injury, and discusses their contribution to our understanding of the pathophysiology as it relates to prognosis. Advanced neuroimaging techniques discussed include anatomic/structural imaging techniques, such as diffusion tensor imaging and susceptibility-weighted imaging, and functional imaging techniques, such as functional magnetic resonance imaging, perfusion-weighted imaging, magnetic resonance spectroscopy, and positron emission tomography.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Smith, K
Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury Journal Article
In: Nature Reviews Neurology, vol. 8, pp. 474, 2012.
BibTeX | Tags: Imaging & EEG
@article{Smith2012,
title = {Traumatic brain injury: CT scan does not predict outcome of mild traumatic brain injury},
author = {Smith, K},
year = {2012},
date = {2012-01-01},
journal = {Nature Reviews Neurology},
volume = {8},
pages = {474},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Slobounov, S; Gay, M; Johnson, B; Zhang, K
Concussion in athletics: ongoing clinical and brain imaging research controversies Journal Article
In: Brain Imaging and Behavior, vol. 6, pp. 224–243, 2012.
Abstract | Links | BibTeX | Tags: Imaging & EEG
@article{Slobounov2012,
title = {Concussion in athletics: ongoing clinical and brain imaging research controversies},
author = {Slobounov, S and Gay, M and Johnson, B and Zhang, K},
doi = {10.1007/s11682-012-9167-2},
year = {2012},
date = {2012-01-01},
journal = {Brain Imaging and Behavior},
volume = {6},
pages = {224--243},
abstract = {Concussion, the most common form of traumatic brain injury, proves to be increasingly complex and not mild in nature as its synonymous term mild traumatic brain injury (mTBI) would imply. Despite the increasing occurrence and prevalence of mTBI there is no universally accepted definition and conventional brain imaging techniques lack the sensitivity to detect subtle changes it causes. Moreover, clinical management of sports induced mild traumatic brain injury has not changed much over the past decade. Advances in neuroimaging that include electroencephalography (EEG), functional magnetic resonance imaging (fMRI), resting-state functional connectivity, diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRS) offer promise in aiding research into understanding the complexities and nuances of mTBI which may ultimately influence clinical management of the condition. In this paper the authors review the major findings from these advanced neuroimaging methods along with current controversy within this field of research. As mTBI is frequently associated with youth and sports injury this review focuses on sportsaEurorelated mTBI in the younger population.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Krishna, Ranga; Grinn, Michael; Giordano, Nicholas; Thirunavukkarasu, Magesh; Tadi, Prasanna; Das, Shibani
Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report Journal Article
In: Journal of Medical Case Reports, vol. 6, pp. 66, 2012.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Krishna2012,
title = {Diagnostic confirmation of mild traumatic brain injury by diffusion tensor imaging: a case report},
author = {Krishna, Ranga and Grinn, Michael and Giordano, Nicholas and Thirunavukkarasu, Magesh and Tadi, Prasanna and Das, Shibani},
year = {2012},
date = {2012-01-01},
journal = {Journal of Medical Case Reports},
volume = {6},
pages = {66},
address = {Medical Clinic of New York, 1513 Voorhies Avenue, Brooklyn, New York 11235, USA. rkrishna@pol.net.},
abstract = {UNLABELLED: ABSTRACT: INTRODUCTION: Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques. CASE PRESENTATION: This is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy. CONCLUSION: Minor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Keefer, Raina
In the game Journal Article
In: ACR Bulletin, vol. 67, no. 10, pp. 10–12, 2012, ISBN: 0098-6070.
BibTeX | Tags: Athletes, Brain -- Pathology, Brain Concussion -- Classification, Brain Concussion -- Complications, Brain Concussion -- Epidemiology -- United States, Brain Concussion -- Pathology, Brain Injuries -- Diagnosis, DIAGNOSTIC imaging, football, FOOTBALL injuries, Imaging & EEG, Physiopathology, Radiologists, Severity of Injury
@article{Keefer2012,
title = {In the game},
author = {Keefer, Raina},
isbn = {0098-6070},
year = {2012},
date = {2012-01-01},
journal = {ACR Bulletin},
volume = {67},
number = {10},
pages = {10--12},
keywords = {Athletes, Brain -- Pathology, Brain Concussion -- Classification, Brain Concussion -- Complications, Brain Concussion -- Epidemiology -- United States, Brain Concussion -- Pathology, Brain Injuries -- Diagnosis, DIAGNOSTIC imaging, football, FOOTBALL injuries, Imaging \& EEG, Physiopathology, Radiologists, Severity of Injury},
pubstate = {published},
tppubtype = {article}
}
Gonzalez, Peter G; Walker, Matthew T
Imaging modalities in mild traumatic brain injury and sports concussion Journal Article
In: PM & R, vol. 3, pp. S413–24, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Gonzalez2011,
title = {Imaging modalities in mild traumatic brain injury and sports concussion},
author = {Gonzalez, Peter G and Walker, Matthew T},
year = {2011},
date = {2011-01-01},
journal = {PM \& R},
volume = {3},
pages = {S413--24},
address = {Department of Physical Medicine and Rehabilitation, Eastern Virginia Medical School, 721 Fairfax Ave, 3rd Floor, Norfolk VA, 23507(+).},
abstract = {Mild traumatic brain injury is a significant public health issue that has been gaining considerable attention over the past few years. After injury, a large percentage of patients experience postconcussive symptoms that affect work and school performance and that carry significant medicolegal implications. Conventional imaging modalities (computed tomography and magnetic resonance imaging) are insensitive to microstructural changes and underestimate the degree of diffuse axonal injury and metabolic changes. Newer imaging techniques have attempted to better diagnose and characterize diffuse axonal injury and the metabolic and functional aspects of traumatic brain injury. The following review article summarizes the currently available imaging studies and describes the novel and more investigational techniques available for mild traumatic brain injury. A suggested algorithm is offered.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Pulsipher, Dalin T; Campbell, Richard A; Thoma, Robert; King, John H
A critical review of neuroimaging applications in sports concussion Journal Article
In: Current Sports Medicine Reports, vol. 10, pp. 14–20, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Pulsipher2011,
title = {A critical review of neuroimaging applications in sports concussion},
author = {Pulsipher, Dalin T and Campbell, Richard A and Thoma, Robert and King, John H},
year = {2011},
date = {2011-01-01},
journal = {Current Sports Medicine Reports},
volume = {10},
pages = {14--20},
address = {Department of Psychiatry, University of New Mexico Health Sciences Center, Center for Neuropsychological Services, University of New Mexico, Albuquerque, NM 87131-0001, USA. dalin.pulsipher@my.rfums.org},
abstract = {While abnormalities related to concussion are typically not identified on traditional clinical neuroimaging (i.e., computed tomography [CT] or magnetic resonance imaging [MRI]), more sophisticated neuroimaging techniques have the potential to reveal the complex neurometabolic processes related to concussion and its recovery. Clinically, these techniques may one day provide useful information to guide clinicians in the management and treatment of sports concussion. This article critically reviews the current state of the literature regarding neuroimaging and sports concussion, identifies challenges in the application of these techniques, and identifies areas for future research.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Gosselin, N; Bottari, C; Chen, J K; Petrides, M; Tinawi, S; de Guise, E; Ptito, A
Electrophysiology and functional MRI in post-acute mild traumatic brain injury Journal Article
In: Journal of Neurotrauma, vol. 28, pp. 329–341, 2011, ISSN: 0897-7151.
Abstract | Links | BibTeX | Tags: Imaging & EEG
@article{Gosselin2011,
title = {Electrophysiology and functional MRI in post-acute mild traumatic brain injury},
author = {Gosselin, N and Bottari, C and Chen, J K and Petrides, M and Tinawi, S and de Guise, E and Ptito, A},
doi = {10.1089/neu.2010.1493},
issn = {0897-7151},
year = {2011},
date = {2011-01-01},
journal = {Journal of Neurotrauma},
volume = {28},
pages = {329--341},
abstract = {Symptoms persisting beyond the acute phase (\>2 months) after a mild traumatic brain injury (MTBI) are often reported, but their origin remains controversial. Some investigators evoke dysfunctional cerebral mechanisms, while others ascribe them to the psychological consequences of the injury. We address this controversy by exploring possible cerebral dysfunction with functional magnetic resonance imaging (fMRI) and event-related potentials (ERP) in a group of patients during the post-acute phase. Fourteen MTBI symptomatic patients (5.7 +/- 2.9 months post-injury) were tested with fMRI and ERP using a visual externally ordered working memory task, and were compared with 23 control subjects. Attenuated blood oxygen level dependent (BOLD) signal changes in the left and right mid-dorsolateral prefrontal cortex (mid-DLPFC), the putamen, the body of the caudate nucleus, and the right thalamus were found in the MTBI group compared with the control group. Moreover, symptom severity and BOLD signal changes were correlated: patients with more severe symptoms had lower BOLD signal changes in the right mid-DLPFC. For ERP, a group x task interaction was observed for N350 amplitude. A larger amplitude for the working memory task than for the control task was found in control subjects, but not in MTBI subjects, who had weak amplitudes for both tasks. This study confirms that persistent symptoms after MTBI cannot be uniquely explained by psychological factors, such as depression and/or malingering, and indicates that they can be associated with cerebral dysfunction. ERP reveals decreased amplitude of the N350 component, while fMRI demonstrates that the more severe the symptoms, the lower the BOLD signal changes in the mid-DLPFC.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Prabhu, Sanjay P
The role of neuroimaging in sport-related concussion Journal Article
In: Clinics in Sports Medicine, vol. 30, pp. 103–114, 2011.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Prabhu2011,
title = {The role of neuroimaging in sport-related concussion},
author = {Prabhu, Sanjay P},
year = {2011},
date = {2011-01-01},
journal = {Clinics in Sports Medicine},
volume = {30},
pages = {103--114},
address = {Division of Neuroradiology, Department of Radiology, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, USA. sanjay.prabhu@childrens.harvard.edu},
abstract = {This article describes some of the newer techniques that are being used in the clinical assessment of patients following mild to moderate TBI, addresses their use in the acute setting, and explores their potential role in long-term follow-up. Also addressed are the challenges faced before some of these newer techniques can be incorporated into routine clinical management. Large studies are needed with a special emphasis on the effects of repeated head trauma in the young athlete. This is especially relevant where conventional imaging does not demonstrate a macroscopic abnormality. The emphasis has to shift from identifying structural abnormalities on imaging studies to understanding the functional changes in the brain that may explain the long-term neuropsychological effects of concussion and mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Grossman, Elan J; Inglese, Matilde; Bammer, Roland
Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine? Journal Article
In: Topics in Magnetic Resonance Imaging, vol. 21, pp. 379–386, 2010.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Grossman2010,
title = {Mild traumatic brain injury: is diffusion imaging ready for primetime in forensic medicine?},
author = {Grossman, Elan J and Inglese, Matilde and Bammer, Roland},
year = {2010},
date = {2010-01-01},
journal = {Topics in Magnetic Resonance Imaging},
volume = {21},
pages = {379--386},
address = {Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, NY, USA.},
abstract = {ABSTRACT: Mild traumatic brain injury (MTBI) is difficult to accurately assess with conventional imaging because such approaches usually fail to detect any evidence of brain damage. Recent studies of MTBI patients using diffusion-weighted imaging and diffusion tensor imaging suggest that these techniques have the potential to help grade tissue damage severity, track its development, and provide prognostic markers for clinical outcome. Although these results are promising and indicate that the forensic diagnosis of MTBI might eventually benefit from the use of diffusion-weighted imaging and diffusion tensor imaging, healthy skepticism and caution should be exercised with regard to interpreting their meaning because there is no consensus about which methods of data analysis to use and very few investigations have been conducted, of which most have been small in sample size and examined patients at only one time point after injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Rabb, C H
Comments Journal Article
In: Neurosurgery, vol. 67, no. 4, pp. 1027–1028, 2010, ISBN: 0148-396X.
BibTeX | Tags: brain concussion, functional magnetic resonance imaging, human, Imaging & EEG, mental task, neuroimaging, Note, priority journal, sport injury, working memory Overviews
@article{Rabb2010,
title = {Comments},
author = {Rabb, C H},
isbn = {0148-396X},
year = {2010},
date = {2010-01-01},
journal = {Neurosurgery},
volume = {67},
number = {4},
pages = {1027--1028},
keywords = {brain concussion, functional magnetic resonance imaging, human, Imaging \& EEG, mental task, neuroimaging, Note, priority journal, sport injury, working memory Overviews},
pubstate = {published},
tppubtype = {article}
}
Jacobs, Bram; Beems, Tjemme; Stulemeijer, Maja; van Vugt, Arie B; van der Vliet, Ton M; Borm, George F; Vos, Pieter E
Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities Journal Article
In: Journal of Neurotrauma, vol. 27, pp. 655–668, 2010.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Jacobs2010,
title = {Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities},
author = {Jacobs, Bram and Beems, Tjemme and Stulemeijer, Maja and van Vugt, Arie B and van der Vliet, Ton M and Borm, George F and Vos, Pieter E},
year = {2010},
date = {2010-01-01},
journal = {Journal of Neurotrauma},
volume = {27},
pages = {655--668},
address = {Department of Neurology, Radboud University Nijmegen Medical Centre (RUNMC), Nijmegen, the Netherlands.},
abstract = {Mild traumatic brain injury (mTBI) is a common heterogeneous neurological disorder with a wide range of possible clinical outcomes. Accurate prediction of outcome is desirable for optimal treatment. This study aimed both to identify the demographic, clinical, and computed tomographic (CT) characteristics associated with unfavorable outcome at 6 months after mTBI, and to design a prediction model for application in daily practice. All consecutive mTBI patients (Glasgow Coma Scale [GCS] score: 13-15) admitted to our hospital who were age 16 or older were included during an 8-year period as part of the prospective Radboud University Brain Injury Cohort Study (RUBICS). Outcome was assessed at 6 months post-trauma using the Glasgow Outcome Scale-Extended (GOSE), dichotomized into unfavorable (GOSE score 1-6) and favorable (GOSE score 7-8) outcome groups. The predictive value of several variables was determined using multivariate binary logistic regression analysis. We included 2784 mTBI patients and found CT abnormalities in 20.7% of the 1999 patients that underwent a head CT. Age, extracranial injuries, and day-of-injury alcohol intoxication proved to be the strongest outcome predictors. The presence of facial fractures and the number of hemorrhagic contusions emerged as CT predictors. Furthermore, we showed that the predictive value of a scheme based on a modified Injury Severity Score (ISS), alcohol intoxication, and age equalled the value of one that also included CT characteristics. In fact, it exceeded one that was based on CT characteristics alone. We conclude that, although valuable for the identification of the individual mTBI patient at risk for deterioration and eventual neurosurgical intervention, CT characteristics are imperfect predictors of outcome after mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Schrader, Harald; Mickeviciene, Dalia; Gleizniene, Rymante; Jakstiene, Silvija; Surkiene, Danguole; Stovner, Lars Jacob; Obelieniene, Diana
Magnetic resonance imaging after most common form of concussion Journal Article
In: BMC Medical Imaging, vol. 9, pp. 11, 2009.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Schrader2009,
title = {Magnetic resonance imaging after most common form of concussion},
author = {Schrader, Harald and Mickeviciene, Dalia and Gleizniene, Rymante and Jakstiene, Silvija and Surkiene, Danguole and Stovner, Lars Jacob and Obelieniene, Diana},
year = {2009},
date = {2009-01-01},
journal = {BMC Medical Imaging},
volume = {9},
pages = {11},
address = {Department of Neurology and Clinical Neurophysiology, Trondheim University Hospital, 7006 Trondheim, Norway. harald.schrader@ntnu.no},
abstract = {BACKGROUND: Until now there is a lack of carefully controlled studies with conventional MR imaging performed exclusively in concussion with short lasting loss of consciousness (LOC). METHODS: A MR investigation was performed within 24 hours and after 3 months in 20 patients who had suffered a concussion with a verified loss of consciousness of maximally 5 minutes. As a control group, 20 age- and gender matched patients with minor orthopaedic injuries had a MR investigation using the same protocol. RESULTS: In a concussion population with an average LOC duration of 1. 4 minutes no case with unequivocal intracranial traumatic pathology was detected. CONCLUSION: An ordinary concussion with short lasting LOC does not or only seldom result in a degree of diffuse axonal injury (DAI) that is visualized by conventional MR with field strength of 1.0 Tesla (T). Analysis of earlier MR studies in concussion using field strength of 1.5 T as well as of studies with diffusion tensor MR imaging (MR DTI) reveal methodological shortcomings, in particular use of inadequate control groups. There is, therefore, a need for carefully controlled studies using MR of higher field strength and/or studies with MR DTI exclusively in common concussion with LOC of maximally 5 minutes.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Ono, Kenichiro; Wada, Kojiro; Takahara, Takashi; Shirotani, Toshiki
Indications for computed tomography in patients with mild head injury Journal Article
In: Neurologia Medico-Chirurgica, vol. 47, pp. 291–298, 2007.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Ono2007,
title = {Indications for computed tomography in patients with mild head injury},
author = {Ono, Kenichiro and Wada, Kojiro and Takahara, Takashi and Shirotani, Toshiki},
year = {2007},
date = {2007-01-01},
journal = {Neurologia Medico-Chirurgica},
volume = {47},
pages = {291--298},
address = {Department of Neurosurgery, Japan Self Defense Forces Central Hospital, Tokyo.},
abstract = {The factors affecting outcome were analyzed in 1,064 patients, 621 males and 443 females aged 10 to 104 years (mean 46 +/- 23 years), with mild head injury (Glasgow Coma Scale [GCS] score \> or =14) but no neurological signs presenting within 6 hours after injury. Intracranial lesion was found in 4.7% (50/1,064), and 0.66% (7/1,064) required surgical treatment. The Japan Coma Scale (JCS) and GCS assessments were well correlated (r = 0.797). Multivariate analysis revealed significant correlations between computed tomography (CT) abnormality and age \> or =60 years, male sex, JCS score \> or =1, alcohol consumption, headache, nausea/vomiting, and transient loss of consciousness (LOC)/amnesia. Univariate analysis revealed that pedestrian in a motor vehicle accident, falling from height, and mechanisms of injuries except blows were correlated to intracranial injury. No significant correlations were found between craniofacial soft tissue injury and intracranial injury. Patients with occipital impact, nonfrontal impact, or skull fracture were more likely have intracranial lesions. Bleeding tendency was not correlated with CT abnormality. The following indications were proposed for CT: JCS score \>0, presence of accessory symptoms (headache, nausea/vomiting, LOC/amnesia), and age \> or =60 years. These criteria would reduce the frequency of CT by 29% (309/1,064). Applying these indications to subsequent patients with GCS scores 14-15, 114 of 168 patients required CT, and intracranial lesions were found in 13. Two refused CT. Fifty-four of the 168 patients did not need CT according to the indications, but 38 of the 54 patients actually underwent CT because of social reasons (n = 21) or patient request (n = 17). These indications for CT including JCS may be useful in the management of patients with mild head injury.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Cohen, B A; Inglese, M; Rusinek, H; Babb, J S; Grossman, R I; Gonen, O
Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury Journal Article
In: AJNR: American Journal of Neuroradiology, vol. 28, pp. 907–913, 2007.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Cohen2007,
title = {Proton MR spectroscopy and MRI-volumetry in mild traumatic brain injury},
author = {Cohen, B A and Inglese, M and Rusinek, H and Babb, J S and Grossman, R I and Gonen, O},
year = {2007},
date = {2007-01-01},
journal = {AJNR: American Journal of Neuroradiology},
volume = {28},
pages = {907--913},
address = {Department of Radiology, New York University School of Medicine, New York, NY 10016, USA. oded.gonen@med.nyu.edu},
abstract = {BACKGROUND AND PURPOSE: More than 85% of brain traumas are classified as "mild"; MR imaging findings are minimal if any and do not correspond to clinical symptoms. Our goal, therefore, was to quantify the global decline of the neuronal marker N-acetylaspartate (NAA), as well as gray (GM) and white matter (WM) atrophy after mild traumatic brain injury (mTBI). MATERIALS AND METHODS: Twenty patients (11 male, 9 female; age range, 19-57 years; median, 35 years) with mTBI (Glasgow Coma Scale score 13-15 with loss of consciousness for at least 30 seconds) and 19 age- and sex-matched control subjects were studied. Seven patients were studied within 9 days of TBI; the other 13 ranged from 1.2 months to 31.5 years (average and median of 4.6 and 1.7 years, respectively) after injury. Whole-brain NAA (WBNAA) concentration was obtained in all subjects with nonlocalizing proton MR spectroscopy. Brain volume and GM and WM fractions were segmented from T1-weighted MR imaging and normalized to the total intracranial volume, suitable for intersubject comparisons. The data were analyzed with least squares regression. RESULTS: Patients with mTBI exhibited, on average, a 12% WBNAA deficit that increased with age, compared with the control subjects (p\<.05). Adjusted for age effects, patients also suffered both global atrophy (-1.09%/year; P=.029) and GM atrophy (-0.89%/year; P=.042). Patients with and without visible MR imaging pathology, typically punctate foci of suspected shearing injury, were indistinguishable in both atrophy and WBNAA. CONCLUSION: WBNAA detected neuronal/axonal injury beyond the minimal focal MR-visible lesions in mTBI. Combined with GM atrophy, the findings may provide further, noninvasive insight into the nature and progression of mTBI.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Gowda, N K; Agrawal, D; Bal, C; Chandrashekar, N; Tripati, M; Bandopadhyaya, G P; Malhotra, A; Mahapatra, A K
Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study Journal Article
In: AJNR: American Journal of Neuroradiology, vol. 27, pp. 447–451, 2006.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Gowda2006,
title = {Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study},
author = {Gowda, N K and Agrawal, D and Bal, C and Chandrashekar, N and Tripati, M and Bandopadhyaya, G P and Malhotra, A and Mahapatra, A K},
year = {2006},
date = {2006-01-01},
journal = {AJNR: American Journal of Neuroradiology},
volume = {27},
pages = {447--451},
address = {Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi.},
abstract = {PURPOSE: To explore the role of single-photon emission CT (SPECT) in initial diagnostic evaluation of patients with mild traumatic brain injury (MTBI) and to identify subgroups in which it may serve as a useful diagnostic tool. MATERIALS AND METHODS: Patients with MTBI seen during a 14-month period were prospectively included in this study. All patients had a CT of head within 12 hours of injury and SPECT by using technetium Tc99m ethyl cysteinate dimer (Tc99m-ECD) within 72 hours of injury. Both SPECT and CT findings were compared with clinical features such as posttraumatic amnesia (PTA), postconcussion syndrome (PCS), and loss of consciousness (LOC). RESULTS: Ninety-two patients with MTBI underwent SPECT in the study period. There were 28 children and 64 adults, with male-to-female ratio of 4.5 to 1. CT findings were abnormal in 31 (34%) and SPECT in 58 (63%). The most common abnormality was hypoperfusion in the frontal lobe(s) in adults and the temporal lobe in children. A significantly higher number of perfusion abnormalities were seen in patients with PTA (P = .03), LOC (P = .02), and PCS (P = .01) than in patients without these symptoms. Compared to CT, SPECT had a much higher sensitivity for detecting an organic basis in these subgroup, of patients (P \< .05). CONCLUSION: Tc99m-ECD SPECT can be used as a complementary technique to CT in initial evaluation of patients with MTBI. It is particularly useful in patients having PCS, LOC, or PTA with normal CT scan.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Abu-Judeh, H H; Parker, R; Aleksic, S; Singh, M L; Naddaf, S; Atay, S; Kumar, M; Omar, W; El-Zeftawy, H; Luo, J Q; Abdel-Dayem, H M
SPECT brain perfusion findings in mild or moderate traumatic brain injury Journal Article
In: Nuclear Medicine Review, vol. 3, pp. 5–11, 2000.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Abu-Judeh2000,
title = {SPECT brain perfusion findings in mild or moderate traumatic brain injury},
author = {Abu-Judeh, H H and Parker, R and Aleksic, S and Singh, M L and Naddaf, S and Atay, S and Kumar, M and Omar, W and El-Zeftawy, H and Luo, J Q and Abdel-Dayem, H M},
year = {2000},
date = {2000-01-01},
journal = {Nuclear Medicine Review},
volume = {3},
pages = {5--11},
address = {Abu-Judeh,H H. Department of Neurology, NYU Medical Center, New York, New York, USA.},
abstract = {BACKGROUND: The purpose of this manuscript is to present the findings in the largest series of SPECT brain perfusion imaging reported to date for mild or moderate traumatic brain injury. PATIENTS AND METHODS: This is a retrospective evaluation of 228 SPECT brain perfusion-imaging studies of patients who suffered mild or moderate traumatic brain injury with or without loss of consciousness (LOC). All patients had no past medical history of previous brain trauma, neurological, or psychiatric diseases, HIV, alcohol or drug abuse. The patient population included 135 males and 93 females. The ages ranged from 11-88 years (mean 40.8). The most common complaints were characteristic of the postconcussion syndrome: headaches 139/228 (61%); dizziness 61/228 (27%); and memory problems 63/228 (28%). LOC status was reported to be positive in 121/228 (53%), negative in 41/228 (18%), and unknown for 63/228 (28%). RESULTS: Normal studies accounted for 52/228 (23%). For abnormal studies (176/228 or 77%) the findings were as follows: basal ganglia hypoperfusion 338 lesions (55.2%); frontal lobe hypoperfusion 146 (23.8%); temporal lobes hypoperfusion 80 (13%); parietal lobes hypoperfusion 20 (3.7%); insular and or occipital lobes hypoperfusion 28 (4.6%). Patients' symptoms correlated with the SPECT brain perfusion findings. The SPECT BPI studies in 122/228 (54%) were done early within 3 months of the date of the accident, and for the remainder, 106/228 (46%) over 3 months and less than 3 years from the date of the injury. In early imaging, 382 lesions were detected; in 92 patients (average 4.2 lesions per study) imaging after 3 months detected 230 lesions: in 84 patients (average 2.7 lesions per study). CONCLUSIONS: Basal ganglia hypoperfusion is the most common abnormality following mild or moderate traumatic brain injury (p = 0.006), and is more common in patients complaining of memory problem (p = 0.0005) and dizziness (p = 0.003). Early imaging can detect more lesions than delayed imaging (p = 0.0011). SPECT brain perfusion abnormalities can occur in the absence of LOC.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Iverson, G L; Lovell, M R; Smith, S; Franzen, M D
Prevalence of abnormal CT-scans following mild head injury Journal Article
In: Brain Injury, vol. 14, pp. 1057–1061, 2000.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Iverson2000,
title = {Prevalence of abnormal CT-scans following mild head injury},
author = {Iverson, G L and Lovell, M R and Smith, S and Franzen, M D},
year = {2000},
date = {2000-01-01},
journal = {Brain Injury},
volume = {14},
pages = {1057--1061},
address = {University of British Columbia, Vancouver, Canada. giverson@interchange.ubc.ca},
abstract = {PRIMARY OBJECTIVE: The purpose of this study was to examine the prevalence of day-of-injury intracranial abnormalities in a large sample of patients with mild head injuries who were admitted to a Trauma Service. METHODS AND PROCEDURES: There were 912 patients who obtained admission Glasgow Coma Scale (GCS) scores of 13-15. MAIN OUTCOMES AND RESULTS: The base rate of complicated mild head injuries (i.e. abnormal CT scans) in this sample was 15.8%. However, nearly 25% of the sample, most of whom had very mild injuries, did not receive CT-scans. Therefore, the actual prevalence is more likely in the range 16-21%. There was a tremendous overlap in injury characteristics between patients with complicated and uncomplicated mild head injuries. None the less, there were modest, yet statistically significant, relationships between the presence of intracranial abnormalities and lower GCS scores, greater frequency of positive loss of consciousness, greater frequency of skull fractures, and lower GOAT scores.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Freed, S; Hellerstein, L F
Visual electrodiagnostic findings in mild traumatic brain injury Journal Article
In: Brain Injury, vol. 11, pp. 25–36, 1997.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Freed1997,
title = {Visual electrodiagnostic findings in mild traumatic brain injury},
author = {Freed, S and Hellerstein, L F},
year = {1997},
date = {1997-01-01},
journal = {Brain Injury},
volume = {11},
pages = {25--36},
address = {Colorado Eye Center/Ophthalmology, Physiology Laboratory, Denver, USA.},
abstract = {Patients with traumatic brain injury (TBI) frequently exhibit varied forms of visual system dysfunction including: binocular, oculomotor, accommodative, refractive error shift, visual field loss, and visual perceptual deficits. A 5-year collaborative study between optometry and ophthalmology was initiated to follow documented mild TBI patients utilizing diagnostic methods to assess the quantity and quality of visual system deficits and recovery. A group of patients with mild TBI receiving optometric rehabilitation were compared with a group of age-matched, gender-matched, and headsize-matched TBI patients not receiving such treatment. Eighteen patients diagnosed with mild TBI underwent a treatment regimen of optometric rehabilitation (group I); 32 patients diagnosed with mild TBI did not receive optometric rehabilitation (group II). Pattern visually evoked cortical potential (VECP) testing and electroretinography (ERG) evaluation were utilized initially, repeated 6-12 months later and then 12-18 months after baseline. All TBI patients' VECP and ERG results were compared to age-matched, headsize-matched controls. Once the ERG had been used to exclude retinal involvement, identification of visual pathway dysfunction was possible with the VECP. Full-field ERG results in all groups were not remarkable and not sensitive for patients with mild TBI. Initial testing results revealed that 72% of those TBI patients in group I demonstrated VECP waveform abnormalities and 81% of those patients in group II showed waveform dysfunction. In the testing performed 12-18 months later, 38% of group I TBI patients, after receiving a treatment regimen of optometric rehabilitation, showed VECP waveform abnormalities; 78% of group II TBI patients demonstrated waveform abnormalities. VECP evaluation in patients with mild TBI can provide a useful and reliable tool for objective assessment of visual system deficit and recovery. Significant differences in visual system recovery were shown when comparing group I and group II.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Parkinson, D
Evaluating cerebral concussion Journal Article
In: Surgical Neurology, vol. 45, pp. 459–462, 1996.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Parkinson1996,
title = {Evaluating cerebral concussion},
author = {Parkinson, D},
year = {1996},
date = {1996-01-01},
journal = {Surgical Neurology},
volume = {45},
pages = {459--462},
address = {Department of Anatomy, University of Manitoba, Winnipeg, Canada.},
abstract = {Years ago we developed a rat model that was consistently comatose for 1-2 seconds following 50 G acceleration of the head. Motor normalcy returned in about 10 seconds, and normal memory in an hour. There were immediate electroencephalogram and transmitter changes. All these returned to normal within an hour following 1 or 20 such concussions. We could find no light or electron microscopic changes. Halothane anesthesia precludes measurement of coma and introduces distortion of metabolite findings. To date our findings indicated concussion at this level is completely reversible.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Murshid, W R
Role of skull radiography in the initial evaluation of minor head injury: a retrospective study Journal Article
In: Acta Neurochirurgica, vol. 129, pp. 11–14, 1994.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Murshid1994,
title = {Role of skull radiography in the initial evaluation of minor head injury: a retrospective study},
author = {Murshid, W R},
year = {1994},
date = {1994-01-01},
journal = {Acta Neurochirurgica},
volume = {129},
pages = {11--14},
address = {Department of Surgery, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia.},
abstract = {The use of skull radiography in the initial evaluation of minor head injured patients is controversial. In an attempt to evaluate its benefits, a retrospective study of 566 cases subjected to skull radiography following close minor head trauma (Glasgow Coma Scale 13-15), is presented. A skull fracture (linear vault, depressed or base of skull) was present in 64 (11%) cases. Only three (5%) who were found to have a skull fracture on skull radiography developed an intracranial injury which required surgery. Intracranial injuries developed in 19 (3%) cases and were followed by surgery in six (32%). All, except for one case, had a decreased level of consciousness and a Glasgow Coma Scale less than 15, few had focal neurological deficits. Management had not been altered by the results of skull radiography in any of the cases. We concluded that skull radiographs are unnecessary for the decision process in closed minor head injury because management decisions are based primarily on a careful neurological examination. When intracranial injuries are a concern, a CT scan should be obtained.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Servadei, F
Is skull X-ray necessary after milder head trauma? Journal Article
In: British Journal of Neurosurgery, vol. 6, pp. 167–168, 1992.
BibTeX | Tags: Imaging & EEG
@article{Servadei1992,
title = {Is skull X-ray necessary after milder head trauma?},
author = {Servadei, F},
year = {1992},
date = {1992-01-01},
journal = {British Journal of Neurosurgery},
volume = {6},
pages = {167--168},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Snow, R B; Zimmerman, R D; Gandy, S E; Deck, M D
Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury Journal Article
In: Neurosurgery, vol. 18, pp. 45–52, 1986.
Abstract | BibTeX | Tags: Imaging & EEG
@article{Snow1986,
title = {Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury},
author = {Snow, R B and Zimmerman, R D and Gandy, S E and Deck, M D},
year = {1986},
date = {1986-01-01},
journal = {Neurosurgery},
volume = {18},
pages = {45--52},
abstract = {Thirty-five patients who had incurred head trauma were studied with computed tomography (CT) and magnetic resonance imaging (MRI). CT was performed using a General Electric 8800 scanner. MRI was conducted with a Technicare Teslacon system using a 5.0 kG (0.5 T) magnetic field. Clinically, patients varied from those with mild concussions without focal neurological signs to those with severe neurological dysfunction including posttraumatic coma. MRI was superior to CT in imaging 23 of 41 extracerebral fluid collections, both in estimating the size of the collections and in diagnosing small collections. MRI was also superior to CT in distinguishing chronic subdural hematomas from hygromas. Further, MRI was superior to CT in visualizing nonhemorrhagic contusion in 15 of 21 lesions. Because of the potential failure of MRI to diagnose acute subarachnoid or acute parenchymal hemorrhage, CT remains the procedure of choice in diagnosing head injury less than 72 hours old.},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}
Sekino, H; Nakamura, N; Yuki, K; Satoh, J; Kikuchi, K; Sanada, S
Brain lesions detected by CT scans in cases of minor head injuries Journal Article
In: Neurologia Medico-Chirurgica, vol. 21, pp. 677–683, 1981.
BibTeX | Tags: Imaging & EEG
@article{Sekino1981,
title = {Brain lesions detected by CT scans in cases of minor head injuries},
author = {Sekino, H and Nakamura, N and Yuki, K and Satoh, J and Kikuchi, K and Sanada, S},
year = {1981},
date = {1981-01-01},
journal = {Neurologia Medico-Chirurgica},
volume = {21},
pages = {677--683},
keywords = {Imaging \& EEG},
pubstate = {published},
tppubtype = {article}
}