Neuroimaging in pediatric traumatic brain injury: Current and future predictors of functional outcome

Abstract

Although neuroimaging has long played a role in the acute management of pediatric traumatic brain injury (TBI), until recently, its use as a tool for understanding and predicting long-term brain-behavior relationships after TBI has been limited by the relatively poor sensitivity of routine clinical imaging for detecting diffuse axonal injury (DAI). Newer magnetic resonance-based imaging techniques demonstrate improved sensitivity to DAI. Early research suggests that these techniques hold promise for identifying imaging predictors and correlates of chronic function, both globally and within specific neuropsychological domains. In this review, we describe the principles of new, advanced imaging techniques including diffusion weighted and diffusion tensor imaging, susceptibility weighted imaging, and 1H-magnetic resonance spectroscopy. In addition, we summarize current research demonstrating their early success in establishing relationships between imaging measures and functional outcomes after TBI. With the ongoing research, these imaging techniques may allow earlier identification of possible chronic sequelae of tissue injury for each child with TBI, thereby facilitating efficacy and efficiency in delivering successful rehabilitation services.

Online Problem-Solving Therapy for Executive Dysfunction After Child Traumatic Brain Injury

“…CT scans performed acutely were not used as a marker of severity because CTs are not particularly more predictive of cognitive and behavioral outcomes than GCS or other clinical factors in the subacute period. 37,40,41 Exclusion criteria included nonblunt trauma, primary language other than English, history of significant intellectual disability before injury, history of child abuse, insufficient recovery to allow participation in the study, history of parental or child psychiatric hospitalization within 1 year before enrollment, Internet access, and shown how to log on to the study web site and access the links to TBI resources on the web.…”

Emerging Imaging Tools for Use with Traumatic Brain Injury Research

“…Finally, we identify some of the general and unique challenges that users of the emerging imaging CDEs may wish to consider. The emerging neuroimaging tools commented upon in this article include: multi-slice CT volumetric MRI analysis susceptibility-weighted imaging (SWI) diffusion tensor imaging (DTI) magnetization transfer imaging (MTI) arterial spin tag labeling (ASL) functional MRI (fMRI), including resting state and connectivity MRI MR spectroscopy (MRS) PET and single photon emission computed tomography (SPECT) MSI or MEG hyperpolarization scanning Several excellent reviews of the use of some of these techniques in TBI have been previously published, and may provide additional information (Ashwal et al, 2006a;Belanger et al, 2007;Coles, 2007;Gallagher et al, 2007;Hillary et al, 2002;Kou et al, 2010;Suskauer and Huisman, 2009;Tshibanda et al, 2009;Van Boven et al, 2009). As with all the CDE recommendations, the selection of recommended outcome measures is an evolving process and recommendations may change with additional evidence and ongoing discussion regarding the current CDEs.…”

The correlation of serum nt-probnp levels of hemorragic and ischemic lesions detected with diffusion MRI in head traumas

“…The median age of the control group was 35, 3±17, 4. Figure 1, and the distribution of pathologies identified by the 48 th hour DWI according to the 48 th hour NT-proBNP values are shown in Figure 2. dISCuSSIon Identification of the amount and characteristics of brain damage in the shortest time possible following head trauma has been demonstrated to be important in estimating its results in the long run and the consequences (19). Numerous researchers, in recent years, have been emphasizing the role of brain injuries in the formation of neurocognitive deficits and behavioral abnormalities.…”