Neuroimaging in traumatic brain imaging

Lee, Bruce; Newberg, Andrew

doi:10.1007/bf03206678

Cited by 29 publications

(39 citation statements)

References 129 publications

(85 reference statements)

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“…Although numerous criteria have been developed to guide neuroimaging decisions after head trauma, none are sensitive and specific enough to diagnose all intracranial pathology. [65][66][67][68][69] at high risk of a structural brain injury identified on CT scan after a head injury. 70 Approximately 22% of the head injuries in this study were sport-related.…”

Section: Neuroimagingmentioning

confidence: 99%

“…MRI provides the ability to detect cerebral contusion, petechial hemorrhage, and white matter injury at a level superior to CT. 65 An MRI may be more appropriate if imaging is needed for an athlete 48 hours or longer after an injury and is best coordinated through the primary care or specialist physician evaluating the athlete. Newly emerging MRI modalities, such as gradient echo and perfusion and diffusion tensor imaging, are better than conventional MRI at detecting white matter alteration, especially in the pediatric population.…”

Section: Neuroimagingmentioning

confidence: 99%

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Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

581

445

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Sport-related concussion is a "hot topic" in the media and in medicine. It is a common injury that is likely underreported by pediatric and adolescent athletes. Football has the highest incidence of concussion, but girls have higher concussion rates than boys do in similar sports. A clear understanding of the definition, signs, and symptoms of concussion is necessary to recognize it and rule out more severe intracranial injury. Concussion can cause symptoms that interfere with school, social and family relationships, and participation in sports. Recognition and education are paramount, because although proper equipment, sport technique, and adherence to rules of the sport may decrease the incidence or severity of concussions, nothing has been shown to prevent them. Appropriate management is essential for reducing the risk of long-term symptoms and complications. Cognitive and physical rest is the mainstay of management after diagnosis, and neuropsychological testing is a helpful tool in the management of concussion. Return to sport should be accomplished by using a progressive exercise program while evaluating for any return of signs or symptoms. This report serves as a basis for understanding the diagnosis and management of concussion in children and adolescent athletes.

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Section: Neuroimagingmentioning

confidence: 99%

Section: Neuroimagingmentioning

confidence: 99%

Sport-Related Concussion in Children and Adolescents

Halstead¹,

Walter²

2010

Pediatrics

581

445

View full text Add to dashboard Cite

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“…The ecoplanar gradient sequence at the T2* weighing contributed to demonstrate chronic and acute intra-axial hemorrhage 32 . The utility of FLAIR images in diagnosing swelling and subarachnoid hemorrhage was studied by many researchers 28,29,33 . New discoveries of images through diffusion (diffusion-weighted, apparent diffusion coefficient, diffusion tensor imaging) besides demonstrating diffuse axonal and ischemic lesions better, also indicate the prognostic more precisely [34][35][36][37] .…”

Section: Discussionmentioning

confidence: 99%

Clinical application of magnetic resonance in acute traumatic brain injury

Morais

Spotti

Tognola

et al. 2008

Arq. Neuro-Psiquiatr.

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-Purpose:To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. Method: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. Results: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. Conclusion: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.Key woRDS: magnetic resonance imaging, traumatic brain injury. Aplicação clínica da ressonância magnética em pacientes com traumatismo craniencefálico agudoResumo -Propósito: Avaliar a aplicação clínica da ressonância magnética (RM) em pacientes vítimas de traumatismo craniencefálico (TCe) agudo, na identificação do tipo, número, gravidade e correlação clínica-radiológica. Método: Foram estudados prospectivamente 55 pacientes vítimas de TCe agudo fechado (0-5 dias), por TC e RM, sendo 34 do sexo masculino e 21 do feminino. Resultados: Houve diferença estatisticamente significante (teste McNemar): fraturas de crânio foram detectadas em 29,1% pacientes na TC e 3,6% pela RM; hematoma subdural 10,9% na TC e 36,4% pela RM; lesão axonal difusa (LAD) 1,8% pela TC e 50,9% na RM; contusões corticais 9,1% na TC e 41,8% pela RM, hemorragia subaracnóidea 18,2% na TC e 41,8% pela RM. Conclusão: A RM foi superior à TC na identificação da LAD, hemorragia subaracnóidea, contusões corticais e hematoma subdural agudo, porém inferior no diagnóstico de fraturas. A detecção de LAD pela RM foi associada com maior gravidade do TCe agudo. PALAVRAS-CHAVe: ressonância magnética, traumatismo craniencefálico.

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“…The inconsistency in the definition and classification of head trauma, along with discrepancies in data collection, made these lesions difficult to characterize epidemiologically [10,33].…”

Section: Introductionmentioning

confidence: 99%

Clinical diagnosis versus autopsy diagnosis in head trauma

Velnic¹,

Hanganu²,

Ciudin³

et al. 2017

Romanian Neurosurgery

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Abstract:The correct and complete diagnosis is essential for the adequate care and the favourable clinical evolution of the patients with head trauma. Purpose: To identify the error rate in the clinical diagnosis of head injuries as shown in comparison with the autopsy diagnosis and to identify the most common sources of error. Material and method: We performed a retrospective study based on data from the medical files and the autopsy reports of patients with head trauma who died in the hospital and underwent forensic autopsy. We collected: demographic data, clinical and laboratory data and autopsy findings. To quantify the concordance rate between the clinical diagnosis of death and the autopsy diagnosis we used a 4 classes classification, which ranged from 100% concordance (C1) to total discordance (C4) and two classes of partial discordance: C2 (partial discordance in favour of the clinical diagnosis-missing injuries in the autopsy reports) and C3 (partial discordance in favor of the necroptic diagnosis-missing injuries in the medical files). Data were analyzed with SPSS version 20.0. Results: We analyzed 194 cases of death due to head injuries. We found a total concordance between the clinical death diagnosis and autopsy diagnosis in 30.4% of cases and at least one discrepancy in 69.6% of cases. Increasing the duration of hospitalization directly correlates with the amount of the imaging investigations and these in turn correlates with an increased rate of diagnosis concordance. Among the patients with stage 3 coma who associated a spinal cord injury, we found a partial diagnosis discordance in 50% of cases and a total discordance in 50% of cases, possibly due to the need for conducting emergency imaging investigation and the need for surgical treatment. In cases with partial and total discordant diagnosis, at least one lesion was omitted in 45.1% of the cases. The most commonly omitted injuries in C2 cases were subdural hematoma, intracerebral hematoma and ventricular hemorrhage (21.6%). In C3 cases the most frequently omitted injuries were subarachnoidian hemorrhage and skull base fractures autopsy diagnosis. Autopsy may identify the inconsistencies in diagnosis, the injuries frequently skipped and the factors favoring the discordance rate between the clinical death diagnosis and the autopsy diagnosis, making it a valuable tool for improving the clinical care of the patients with head trauma.

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Neuroimaging in traumatic brain imaging

Cited by 29 publications

References 129 publications

Sport-Related Concussion in Children and Adolescents

Sport-Related Concussion in Children and Adolescents

Clinical application of magnetic resonance in acute traumatic brain injury

Clinical diagnosis versus autopsy diagnosis in head trauma

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