Magnetic resonance imaging evidence of progression of subacute brain atrophy in moderate to severe traumatic brain injury.
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.
Ng
Kevin
K
Department of Medical Imaging, Division of Neuroradiology, University Health Network, University of Toronto.
Mikulis
David J
DJ
Glazer
Joanna
J
Kabani
Noor
N
Till
Christine
C
Greenberg
Gahl
G
Thompson
Andrew
A
Lazinski
Dorothy
D
Agid
Ronit
R
Colella
Brenda
B
Green
Robin E
RE
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