title: Magnetic resonance imaging evidence of progression of subacute brain atrophy in moderate to severe traumatic brain injury.
abstract: OBJECTIVE
  To demonstrate subacute progression of brain atrophy (from 4.5-29mo postinjury) in moderate to severe traumatic brain injury (TBI) using structural magnetic resonance imaging (MRI).
  
  
  METHODS
  Within-subjects, repeated-measures design.
  
  
  METHODS
  Inpatient neurorehabilitation program and teaching hospital (MRI department).
  
  
  METHODS
  Adults (N=14) with moderate to severe TBI.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Neuroradiologist readings and volumetric measurements (total brain cerebrospinal fluid and hippocampus) at 4.5 months and 2.5 years postinjury.
  
  
  RESULTS
  Ten of 14 patients showed visible atrophy progression. Significant increase in cerebrospinal fluid (CSF) volume (t(13)=-4.073, P<.001) and decrease in right and left hippocampal volumes (t(13)=4.221, P<.001 and t(13)=3.078, P<.005, respectively) were observed from 4.5 months to 2.5 years. Compared with published normative data, patients with TBI showed significantly more pathologic percent annual volume change for the hippocampi (t(26)=-3.864, P<.001, right; and t(26)=-2.737, P<.01, left), and a trend for CSF (t(26)=1.655, P=.059).
  
  
  CONCLUSIONS
  This study provides strong MRI evidence for subacute progression of atrophy, as distinct from early, acute neurologic changes observed.
authors.affiliation: Department of Medical Imaging, Division of Neuroradiology, University Health Network, University of Toronto.
authors.forename: Kevin
authors.initials: K
authors.lastname: Ng
authors.forename: David J
authors.initials: DJ
authors.lastname: Mikulis
authors.forename: Joanna
authors.initials: J
authors.lastname: Glazer
authors.forename: Noor
authors.initials: N
authors.lastname: Kabani
authors.forename: Christine
authors.initials: C
authors.lastname: Till
authors.forename: Gahl
authors.initials: G
authors.lastname: Greenberg
authors.forename: Andrew
authors.initials: A
authors.lastname: Thompson
authors.forename: Dorothy
authors.initials: D
authors.lastname: Lazinski
authors.forename: Ronit
authors.initials: R
authors.lastname: Agid
authors.forename: Brenda
authors.initials: B
authors.lastname: Colella
authors.forename: Robin E
authors.initials: RE
authors.lastname: Green
mesh_terms: D000328:Adult; D001284:Atrophy / Q000175:diagnosis / Q000209:etiology; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices; D055815:Young Adult