1H MRS in acute traumatic brain injury.
The objective of this study was to demonstrate 1H MR spectroscopy (MRS) changes in cerebral metabolites after acute head trauma. Twenty-five patients (12 children, 13 adults) were examined with quantitative 1H MRS after closed head injury. Clinical grade (Glasgow Coma Scale [GCS]) and outcome (Rancho Los Amigos Medical Center Outcome Score [ROS]) were correlated with quantitative neurochemical findings. N-acetylaspartate (NAA), a neuronal and axonal marker, was reduced (P < .03-.001). In children, a reduced NAA/creatine plus phosphocreatine (Cr) level and the presence of detectable lipid/lactate predicted bad outcome (sensitivity, 89%; specificity, 89%). The first MRS examination of all patients correlated with ROS versus NAA (r = .65, P < .0001). Although most patients showed MRS abnormalities, striking heterogeneity of 1H MRS characterized the individual patients. 1H MRS identifies multiple patterns of diffuse brain injury after blunt head trauma. There was a strong correlation between MRS and outcome. Future prospective studies will be needed to determine the clinical usefulness of MRS in predicting outcome from closed head injury.
Ross
B D
BD
Huntington Medical Research Institutes, Pasadena, CA 91105, USA.
Ernst
T
T
Kreis
R
R
Haseler
L J
LJ
Bayer
S
S
Danielsen
E
E
Blüml
S
S
Shonk
T
T
Mandigo
J C
JC
Caton
W
W
Clark
C
C
Jensen
S W
SW
Lehman
N L
NL
Arcinue
E
E
Pudenz
R
R
Shelden
C H
CH
D000328:Adult; D001921:Brain / Q000378:metabolism* / Q000473:pathology; D001923:Brain Chemistry; D001930:Brain Injuries / Q000378:metabolism* / Q000473:pathology; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000378:metabolism / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome