Genu of corpus callosum as a prognostic factor in diffuse axonal injury

Matsukawa, Hidetoshi; Shinoda, Masaki; Fujii, Motoharu; Takahashi, Osamu; Yamamoto, Daisuke; Murakata, Atsushi; Ishikawa, Ryo

doi:10.3171/2011.6.jns11513

Cited by 25 publications

(28 citation statements)

References 24 publications

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“…Primary direct contusion likely was a major factor in the evolution of the hematoma in the CC, as penetrating cortical medullary arteries in the CC have their major sweep in the coronal plane and may be vulnerable to shear and stress due to impact along the long axis of the skull. 18) In addition, hemorrhage of the interhemispheric fissure cistern along with the hematoma was found in both of our cases, and this was also found in other studies; 3,19) this may be associated with the delayed hematoma of the CC. Although traumatic intracranial aneurysm is one of the causes of delayed apoplexy in patients with severe head trauma 20) following direct mural injury or acceleration-induced shearing force, 21) neither of our cases showed this vascular abnormality through CTA and/or DSA.…”

Section: Discussionsupporting

confidence: 89%

“…4,19),32) Poor outcome is associated with increasing age, low admission GCS, and the presence of space-occupying lesions, 33,34) especially those that involve both the genu and the splenium. 3) In our case 2, the patient’s GCS level was 15 upon admission, and he experienced immediate onset of coma and underwent emergency surgery. In case 2, a relatively low ICP was observed postoperatively until the patient died.…”

Section: Discussionmentioning

confidence: 67%

“…However, massive traumatic hematomas in the region of the corpus callosum (CC) have been found to be uncommon, and delayed hematoma in this region is very rare, although small hemorrhagic foci in the CC or surrounding structures are frequently seen in shearing injuries of the cerebral white matter 1) or in diffuse axonal injuries (DAIs). 2,3) Little is known about delayed hematomas in the CC, and generally they are mentioned only incidentally among other findings. In this report, two cases with delayed massive hematoma of the CC produced by blunt head injury are described, and their possible dynamic mechanisms as well as clinical considerations are discussed.…”

Section: Introductionmentioning

confidence: 99%

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Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

Han

Zheng

et al. 2014

NMC Case Report Journal

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A delayed massive traumatic hematoma in the corpus callosum is extremely rare. We report two cases with a delayed massive callosal hematoma caused by blunt head trauma. A massive callosal hematoma was diagnosed by computed tomography (CT) 2 weeks after a minor head injury in a 29-year-old man. A similar but larger hematoma developed 12 hours post-trauma with acute onset of consciousness disturbance in a 39-year-old man. Emergency CT angiography revealed no vascular pathologies in either case. The first patient was managed conservatively and recovered, whereas the second patient was treated surgically and died. The literature was reviewed regarding the possible mechanism of production of these lesions following head injury and therapeutic considerations are discussed.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 67%

Section: Introductionmentioning

confidence: 99%

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Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

Han

Zheng

et al. 2014

NMC Case Report Journal

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“…3,11) In this study, there were no differences in outcome according to the location of microbleeds. However, the small number of patients with microbleeds in the corpus callosum and the brainstem limits this comparison, and more patients are needed to address this point.…”

Section: Discussionmentioning

confidence: 65%

Microbleeds as a Prognostic Factor for Acute Subdural Hematoma

Yamaguchi

Takai

Hirai

et al. 2013

Neurol. Med. Chir.(Tokyo)

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This study investigated the frequency of poor outcome at discharge of acute subdural hematoma (SDH) patients with and without microbleeds. We retrospectively examined the records of 37 patients with acute SDH who were surgically treated with hematoma removal and received magnetic resonance (MR) imaging within 2 weeks of head injury onset. MR images were used to determine the presence or absence of microbleeds and contusional hemorrhage (CH). Patient outcome was categorized as good (moderate disability or good recovery) or poor (severely disability, vegetative state, or dead) according to the Glasgow Outcome Scale at discharge. Microbleeds were found in 23 patients (62%) and CH was found in 26 patients (70%). Fifteen patients (41%) had both microbleeds and CH. Poor outcome at discharge was more common in SDH patients with both microbleeds and CH than in SDH patients with neither microbleeds nor CH (14/15, 93% vs. 14/22, 64%; p ＝ 0.04). Poor outcome at discharge was more common in SDH patients under 60 years of age with microbleeds (6/8, 75%) than patients under 60 years of age without microbleeds (0/4, 0%; p ＝ 0.03). The location of the microbleed was not related to the outcome at discharge. These results suggest that the presence of microbleeds and CH on MR images may indicate poor prognosis in patients with acute SDH.

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“…In this patient, the correlation between the lesion and neurological outcome was not clear, because he had already shown delayed development before the accident. Matsukawa et al 6 reported that the presence of a callosal genu lesion suggests disability 1 year after TBI in patients with diffuse axonal injury. In our patient, developmental delay was mild almost equally before and after TBI.…”

Section: Discussionmentioning

confidence: 99%

Isolated Cystic Lesion of the Callosal Genu after Traumatic Brain Injury

et al. 2012

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We report the case of a 17-month-old infant who developed an isolated cystic lesion of the callosal genu as a unique lesion of traumatic axonal injury (TAI). Although one of the most common sites of TAI is the corpus callosum, there have been no reports describing the lesion seen in our patient. Brain computed tomography findings were normal on the day of the traffic accident. After 3 months, brain magnetic resonance imaging showed an isolated cystic lesion of the callosal genu that had the appearance of a cystic cavity. This lesion decreased in size 16 months later. The neuroimaging findings of this patient suggest that an isolated cystic lesion of the callosal genu could appear as a unique form of TAI in infants after traumatic brain injury (TBI), but it is nevertheless important to attend to such lesions in children with TBI.

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Genu of corpus callosum as a prognostic factor in diffuse axonal injury

Abstract: Regardless of the number of lesions, the existence of a genu lesion suggested disability 1 year after TBI in patients with DAI.

Cited by 25 publications

References 24 publications

Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

Delayed Massive Traumatic Hematoma in the Corpus Callosum: Two Case Reports with Literature Review

Microbleeds as a Prognostic Factor for Acute Subdural Hematoma

Isolated Cystic Lesion of the Callosal Genu after Traumatic Brain Injury

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