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MRI evidence of progression of subacute brain atrophy in moderate to severe traumatic brain injury

Full Title: Magnetic resonance imaging evidence of progression of subacute brain atrophy in moderate to severe traumatic brain injury


Ng K, Mikulis D, Glazer J, Kabani N, Till C, Greenberg G, Thomson A, Lazinski D, Agid R, Collela B, Green REA


Archives of Physical Rehabilitation and Medicine


Abstract

Objectives:

To demonstrate subacute progression of brain atrophy (from 4.5-29mo postinjury) in moderate to severe traumatic brain injury (TBI) using structural magnetic resonance imaging (MRI).


Design:

Within-subjects, repeated-measures design.


Setting:

Inpatient neurorehabilitation program and teaching hospital (MRI department).


Participants:

Adults (N=14) with moderate to severe TBI.


Interventions:

Not applicable.


Main outcome measures:

Neuroradiologist readings and volumetric measurements (total brain cerebrospinal fluid and hippocampus) at 4.5 months and 2.5 years postinjury.


Results:

Ten of 14 patients showed visible atrophy progression. Significant increase in cerebrospinal fluid (CSF) volume (t(13)=-4.073, P<.001) and decrease in right and left hippocampal volumes (t(13)=4.221, P<.001 and t(13)=3.078, P<.005, respectively) were observed from 4.5 months to 2.5 years. Compared with published normative data, patients with TBI showed significantly more pathologic percent annual volume change for the hippocampi (t(26)=-3.864, P<.001, right; and t(26)=-2.737, P<.01, left), and a trend for CSF (t(26)=1.655, P=.059).


Conclusions:

This study provides strong MRI evidence for subacute progression of atrophy, as distinct from early, acute neurologic changes observed.


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