Search Our Scientific Publications & Authors

Eur J Neurol 2019 Feb 13. Epub 2019 Feb 13.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Background: Diffuse white matter (WM) injury is prominent in primary progressive multiple sclerosis (PP-MS) pathology and is a potential biomarker of disease progression. Diffusion Kurtosis Imaging (DKI) allows the quantification of non-Gaussian water diffusion, providing metrics with high WM pathological specificity.

Objective: To characterize the pathological changes occurring in the normal appearing white matter (NAWM) of patients with PP-MS at baseline and at 1-year follow-up and to assess their impact on disability and short-term disease progression. Read More

J Neurosurg Pediatr 2019 Feb 8:1-9. Epub 2019 Feb 8.

8Pediatrics, Children's National Medical Center, Washington, DC.

OBJECTIVEThere is no consensus on the optimal timing and specific brain MRI sequences in the evaluation and management of severe pediatric traumatic brain injury (TBI), and information on current practices is lacking. The authors performed a survey of MRI practices among sites participating in a multicenter study of severe pediatric TBI to provide information for designing future clinical trials using MRI to assess brain injury after severe pediatric TBI.METHODSInformation on current imaging practices and resources was collected from 27 institutions participating in the Approaches and Decisions after Pediatric TBI Trial. Read More

BMC Pediatr 2019 Jan 15;19(1):21. Epub 2019 Jan 15.

Department of Pediatric Emergency Medicine, Children's Hospital, China Medical University, Taichung, Taiwan.

Background: Pneumatosis intestinalis and portomesenteric venous gas are usually caused by necrotizing enterocolitis; however they can occur secondary to abusive abdominal trauma with bone fractures and bruising. It is difficult to recognize initially if there is no bruising on the skin or bone fractures.

Case Presentation: We report a 1-year-old child with no obvious history of trauma who presented with conscious disturbance. Read More

Stroke 2019 Feb;50(2):336-343

From the Department of Cardiovascular Sciences, University of Leicester, United Kingdom (N.P., J.J., M.A.H., L.C., E.M.L.C.).

Background and Purpose- Cerebral microbleeds (CMBs) have been observed using magnetic resonance imaging in patients with cardiovascular risk factors, cognitive deterioration, small vessel disease, and dementia. They are a well-known consequence of cerebral amyloid angiopathy, chronic hypertension, and diffuse axonal injury, among other causes. However, the frequency and location of new CMBs postadult cardiac surgery, in association with cognition and perioperative risk factors, have yet to be studied. Read More

Brain Inj 2019 19;33(3):355-363. Epub 2018 Dec 19.

c Department of Radiology , Wayne State University School of Medicine , Detroit , MI , USA.

Purpose Of The Study: To investigate the association among global and regional white matter fractional anisotropy (FA) values following traumatic brain injury (TBI) and cognitive functioning.

Materials And Methods: This research was conducted in an urban rehabilitation hospital. Participants included adults who were healthy controls (n = 18) or who had a TBI (n = 27). Read More

Neural Regen Res 2019 Mar;14(3):413-424

Regenerative Bioscience Center; Department of Animal and Dairy Science, University of Georgia, Athens, GA, USA.

Traumatic brain injury (TBI) is a major contributor of long-term disability and a leading cause of death worldwide. A series of secondary injury cascades can contribute to cell death, tissue loss, and ultimately to the development of functional impairments. However, there are currently no effective therapeutic interventions that improve brain outcomes following TBI. Read More

Medicine (Baltimore) 2018 Nov;97(48):e13315

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University 317-1, Daemyungdong, Namku, Daegu, Republic of Korea.

Rationale: Many studies using diffusion tensor imaging (DTI) have demonstrated traumatic axonal injury (TAI) in patients whose conventional brain magnetic resonance imaging (MRI) results are negative following head trauma. Injury mechanism for TAI in these patients has been mainly associated with motor vehicle accident, whereas very little is known about TAI by violence.

Patient Concerns: A 42-year-old male patient presented after experiencing head trauma due to violence. Read More

J Intern Med 2018 Nov 27. Epub 2018 Nov 27.

Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.

Traumatic brain injury (TBI) is clinically divided into a spectrum of severities, with mild TBI being the least severe form and a frequent occurrence in contact sports, such as ice hockey, American football, rugby, horse riding and boxing. Mild TBI is caused by blunt nonpenetrating head trauma that causes movement of the brain and stretching and tearing of axons, with diffuse axonal injury being a central pathogenic mechanism. Mild TBI is in principle synonymous with concussion; both have similar criteria in which the most important elements are acute alteration or loss of consciousness and/or post-traumatic amnesia following head trauma and no apparent brain changes on standard neuroimaging. Read More

Arq Neuropsiquiatr 2018 Oct;76(10):724-725

Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurocirurgia, São Paulo SP, Brasil.

Int J Law Psychiatry 2018 Nov - Dec;61:50-63. Epub 2018 Nov 1.

Center for Law, Brain and Behavior, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.

Important advances in neuroscience and neuroimaging have revolutionized our understanding of the human brain. Many of these advances provide new evidence regarding compensable injuries that have been used to support changes in legal policy. For example, we now know that regions of the brain involved in decision making continue to develop into the mid-20s, and this information weighs heavily in determining that execution or automatic sentence of life without the possibility of parole for someone younger than 18 years old, at the time of the crime, violates the 8th Amendment prohibition against "cruel and unusual punishment. Read More

Microporous Mesoporous Mater 2018 Oct 25;269:156-159. Epub 2017 Mar 25.

Section on Quantitative Imaging and Tissue Sciences, NICHD, National Institutes of Health, Bethesda, MD, USA.

Double pulsed-field gradient (dPFG) MRI is proposed as a new sensitive tool to detect and characterize tissue microstructure following diffuse axonal injury. In this study dPFG MRI was used to estimate apparent mean axon diameter in a diffuse axonal injury animal model and in healthy fixed mouse brain. Histological analysis was used to verify the presence of the injury detected by MRI. Read More

Leg Med (Tokyo) 2019 Feb 1;36:9-16. Epub 2018 Oct 1.

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Department of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.

In forensic investigations, it is important to detect traumatic axonal injuries (TAIs) to reveal head trauma that might otherwise remain occult. These lesions are subtle and frequently ambiguous on macroscopic evaluations. We present a case of TAI revealed by pre-autopsy postmortem magnetic resonance imaging (PMMR). Read More

Acta Neurochir (Wien) 2018 Dec 24;160(12):2277-2287. Epub 2018 Sep 24.

Section of Brain Physics, Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, CB2 0QQ, UK.

Background: Continuous assessment of cerebral compensatory reserve is possible using the moving correlation between pulse amplitude of intra-cranial pressure (AMP) and intra-cranial pressure (ICP), called RAP. Little is known about the behavior and associations of this index in adult traumatic brain injury (TBI). The goal of this study is to evaluate the association between admission cerebral imaging findings and RAP over the course of the acute intensive care unit stay. Read More

Neurol Neurochir Pol 2018 Nov - Dec;52(6):710-719. Epub 2018 Sep 13.

Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Department of Neurosurgery, University Hospital Tübingen, Tübingen, Germany. Electronic address:

Introduction: Several imaging modalities are under investigation to unravel the pathophysiological mystery of delayed performance deficits in patients after mild traumatic brain injury (mTBI). Although both imaging and neuropsychological studies have been conducted, only few data on longitudinal correlations of diffusion tensor imaging (DTI), susceptibility weighted imaging (SWI) and extensive neuropsychological testing exist.

Methods: MRI with T1- and T2-weighted, SWI and DTI sequences at baseline and 12 months of 30 mTBI patients were compared with 20 healthy controls. Read More

Semin Ultrasound CT MR 2018 Oct 8;39(5):469-480. Epub 2018 Feb 8.

Division of Neuroradiology, University of Cincinnati Medical Center, Cincinnati, OH.

Head trauma is a common indication for neuroimaging in the emergency room. CT is the modality of first choice, as it is quick, safe, and effective in evaluating for life-threatening intracranial hemorrhage and mass effect. CT is also best for evaluating for skull fractures, which may alter management and lead to further imaging studies. Read More

J Neurotrauma 2018 Oct 19. Epub 2018 Oct 19.

1 Department of Psychiatry, Center for the Promotion of Interdisciplinary Education and Research, Kyoto University , Kyoto, Japan .

Diffuse axonal injury (DAI) is characterized by diffuse white matter (WM) disruption caused by shearing forces acting on the brain. Cortical atrophy can be accompanied by WM disruption, which is assumed to reflect the loss of neuron cell bodies in gray matter (GM) regions adjacent to disrupted WM. It remains unclear whether WM disruption leads to regional GM alteration in DAI. Read More

J Neurosurg 2018 Sep 1:1-8. Epub 2018 Sep 1.

1Department of Neuroscience/Neurosurgery, Uppsala University; and.

OBJECTIVEIncreased intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI) with diffuse axonal injury (DAI) is not well defined. This study investigated the occurrence of increased ICP and whether clinical factors and lesion localization on MRI were associated with increased ICP in patients with DAI.METHODSFifty-two patients with severe TBI (median age 24 years, range 9-61 years), who had undergone ICP monitoring and had DAI on MRI, as determined using T2*-weighted gradient echo, susceptibility-weighted imaging, and diffusion-weighted imaging (DWI) sequences, were enrolled. Read More

Child Neurol Open 2018 29;5:2329048X18792441. Epub 2018 Aug 29.

Division of Pediatric Intensive Care, Hasbro Children's Hospital, Providence, RI, USA.

We present a 16-year-old female status post traumatic brain injury from severe motor vehicle crash with prolonged extrication. Initially with a Glasgow Coma Scale of 4 and blood pressure of 80/40, she required emergent intubation. Head computed tomography was notable for skull fracture with hematoma, diffuse axonal injury, and 6-mm midline shift with right uncal herniation. Read More

Brain Inj 2018 ;32(10):1266-1276

h Phantom Metrics Division of Psychology Software Tools Inc , Pittsburgh, Pennsylvania, USA.

Objective: Multisite and longitudinal neuroimaging studies are important in uncovering trajectories of recovery and neurodegeneration following traumatic brain injury (TBI) and concussion through the use of diffusion tensor imaging (DTI) and other imaging modalities. This study assessed differences in anisotropic diffusion measurement across four scanners using a human and a novel phantom developed in conjunction with the Chronic Effects of Neurotrauma Consortium.

Method: Human scans provided measurement within biological tissue, and the novel physical phantom provided measures of anisotropic intra-tubular diffusion to serve as a model for intra-axonal water diffusion. Read More

Emerg Radiol 2018 Dec 22;25(6):691-701. Epub 2018 Aug 22.

Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 648, Rochester, NY, 14642, USA.

Susceptibility-weighted imaging (SWI) plays a key role in an emergency setting. SWI takes the intrinsic properties of materials being scanned and creates a visual representation of their effects on the magnetic field, thereby differentiating a number of pathologies. Magnetic resonance imaging (MRI) is now more often used, especially when computed tomography (CT) is inconclusive or even negative. Read More

Neuroreport 2018 10;29(15):1282-1287

Department of Radiology, The First Affiliated Hospital.

Disrupted white matter structure has been established in patients with diffuse axonal injury (DAI), but morphological changes in gray matter and local intrinsic activity in the short and midterm (before 6 months) have not been documented in DAI patients. We hypothesized that regionally selective atrophy observed in deep gray matter in the short-term and mid-term periods in patients with mild-to-moderate DAI, local atrophy, and/or dysfunction would be related to clinical characteristics. We evaluated the changes in regional density and synchronization in 18 DAI patients separately using Diffeomorphic Anatomical Registration through Exponentiated Lie algebra-enhanced voxel-based morphometry and regional homogeneity (ReHo). Read More

J Magn Reson Imaging 2018 Aug 6. Epub 2018 Aug 6.

Department of Radiology, Second Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.

Background: Diffuse axonal injury (DAI) is one of the devastating types of traumatic brain injury, but is difficult to detect on conventional imaging in its early stages.

Purpose: To test the technical feasibility and diagnostic value of diffusion kurtosis imaging (DKI) and glutamate chemical exchange saturation transfer (GluCEST) imaging in the brain after DAI.

Study Type: Prospective. Read More

Eur Radiol 2019 Mar 31;29(3):1308-1317. Epub 2018 Jul 31.

Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul, 110-744, Korea.

Objectives: To explore the utility of dynamic contrast-enhanced (DCE) MR imaging for quantitative analysis of blood-brain barrier disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS).

Methods: Forty-four consecutive patients with PCS after mTBI and 32 controls were included in this retrospective study. K and v from DCE MR imaging were analyzed at contrast-enhancing lesions, T2 hyperintense white matter (WM) lesions, normal-appearing white matter (NAWM), and predilection sites for diffuse axonal injury (Location). Read More

Neuroimaging Clin N Am 2018 Aug 8;28(3):435-451. Epub 2018 Jun 8.

Department of Radiology, University of Ottawa, The Ottawa Hospital, Civic and General Campus, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada.

Unconsciousness may be due to severe brain damage or to potentially reversible causes. Noncontrast head computed tomography (CT) helps identify acute ischemic and hemorrhagic lesions as well as certain patterns of toxic encephalopathy. MR imaging plays an important role in the assessment of acutely encephalopathic patients who may show no significant abnormality on CT. Read More

Exp Ther Med 2018 Jul 10;16(1):93-102. Epub 2018 May 10.

Department of Neurosurgery, The 306th Hospital of The People's Liberation Army, Beijing 100101, P.R. China.

Although studies concerning blast-related traumatic brain injury (bTBI) have demonstrated the significance of diffuse axonal injury (DAI), no standard models for this type of injury have been widely accepted. The present study investigated a mechanism of inducing DAI through real blast injury, which was achieved by performing instantaneous high-speed swinging of the rat head, thus establishing a stable animal model of blast DAI. Adult Sprague-Dawley rats weighing 150±10 g were randomly divided into experimental (n=16), control (n=10) and sham control (n=6) groups. Read More

Clin Neuropathol 2018 Sep/Oct;37(5):228-231

We describe an unusual leukoencephalopathy in a female who developed global language and memory difficulties as well as diffuse FLAIR lesions in the cerebral white matter (WM) ~ 30 months after bariatric surgery. She had no detectable nutritional deficiency. She died suddenly due to cardiovascular disease. Read More

Brain Imaging Behav 2018 Jun 14. Epub 2018 Jun 14.

Brain and Mind Centre, University of Sydney, Sydney, NSW, Australia.

Adults with severe traumatic brain injury (TBI) often suffer poor social cognition. Social cognition is complex, requiring verbal, non-verbal, auditory, visual and affective input and integration. While damage to focal temporal and frontal areas has been implicated in disorders of social cognition after TBI, the role of white matter pathology has not been examined. Read More

J Neurotrauma 2018 Sep 14. Epub 2018 Sep 14.

1 Department of Clinical Brain Sciences, Gifu University Graduate School of Medicine , Minokamo, Japan .

The aim of this study is to investigate glucose uptake on 18F-fluorodeoxyglucose positron emission tomography positron emission tomography (FDG-PET) in patients with chronic mental and cognitive symptoms following a single blunt mild traumatic brain injury (TBI) and without visible brain lesions on computed tomography (CT)/magnetic resonance imaging (MRI). Eighty-nine consecutive patients (mean age 43.8 ± 10. Read More

Neurosci Biobehav Rev 2018 09 6;92:140-149. Epub 2018 Jun 6.

Monash Alfred Psychiatry Research Centre, The Alfred and Monash University, Central Clinical School, Melbourne, Australia.

The pathophysiology associated with mild traumatic brain injury (mTBI) includes neurometabolic and cytoskeletal changes that have been shown to impair structural and functional connectivity. Evidence that persistent neuropsychological impairments post injury are linked to structural and functional connectivity changes is increasing. However, to date the relationship between connectivity changes, heterogeneity of persistent symptoms and recovery post mTBI has been poorly characterised. Read More

J Neurotrauma 2019 Feb 13;36(4):601-608. Epub 2018 Aug 13.

5 Department of Radiology, Rutgers Biomedical and Health Sciences-New Jersey Medical School , Newark, New Jersey.

Traumatic brain injury (TBI) is a leading cause of morbidity in children. To investigate outcome of early developmental TBI during adolescence, a rat model of fluid percussion injury was developed, where previous work reported deficits in sensorimotor behavior and cortical blood flow at adolescence. Based on the nonlocalized outcome, we hypothesized that multiple neurophysiological components of brain function, namely neuronal connectivity, synapse/axonal microstructural integrity, and neurovascular function, are altered and magnetic resonance imaging (MRI) methods could be used to determine regional alterations. Read More

Arq Neuropsiquiatr 2018 Mar;76(3):189-199

Departamento de Radiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

Traumatic brain injury (TBI) is the number one cause of death and morbidity among young adults. Moreover, survivors are frequently left with functional disabilities during the most productive years of their lives. One main aspect of TBI pathology is diffuse axonal injury, which is increasingly recognized due to its presence in 40% to 50% of all cases that require hospital admission. Read More

J Neurosurg 2018 May 1:1-8. Epub 2018 May 1.

4Exercise & Sport Science Department and.

OBJECTIVERepetitive subconcussive head trauma is a consequence of participation in contact sports and may be linked to neurodegenerative diseases. The degree of neurological injury caused by subconcussive head trauma is not easily detectible, and this injury does not induce readily identifiable clinical signs or symptoms. Recent advancements in immunoassays make possible the detection and quantification of blood biomarkers linked to head trauma. Read More

J Neurotrauma 2018 Oct 2;35(20):2357-2364. Epub 2018 Jul 2.

1 Trauma TopCare and Departments of, Elisabeth Tweesteden Hospital , Tilburg, The Netherlands .

Functional outcome and quality of life are difficult to predict in patients with diffuse axonal injury (DAI) after traumatic brain injury (TBI). The primary aim of this cross-sectional cohort study was to assess the long-term functional outcome in patients with DAI and to identify prognostic factors. Second, health-related quality of life (HRQL) at long-term follow-up was assessed. Read More

Medicine (Baltimore) 2018 May;97(20):e10695

The Third Xiangya Hospital, Central South University, Changsha, China.

Introduction: B lymphoblastic lymphoma (B-LBL) is a rare type of lymphoma that originates from precursor lymphocytes. B-BLB in adults with brain metastases is extremely rare as the disease mainly affects children and adults. Therefore, such a seldom-seen case can easily trigger a dispute regarding clinical diagnosis and treatment. Read More

ASN Neuro 2018 Jan-Dec;10:1759091418770543

1 Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh, PA, USA.

Mild traumatic brain injury (mTBI) in children is a common and serious public health problem. Traditional neuroimaging findings in children who sustain mTBI are often normal, putting them at risk for repeated mTBI (rmTBI). There is a need for more sensitive imaging techniques capable of detecting subtle neurophysiological alterations after injury. Read More

Med Devices (Auckl) 2018 26;11:139-146. Epub 2018 Apr 26.

Department of Neurological Surgery, University of São Paulo School of Medicine, São Paulo, Brazil.

The cost of traumatic brain injury (TBI) for public health policies is undeniable today. Even patients who suffer from mild TBI may persist with cognitive symptoms weeks after the accident. Most of them show no lesion in computed tomography or conventional magnetic resonance imaging, but microstructural white matter abnormalities (diffuse axonal lesion) can be found in diffusion tensor imaging. Read More

Asian J Neurosurg 2018 Apr-Jun;13(2):348-356

Department of Radiology, SMS Medical College, Jaipur, Rajasthan, India.

Objectives: Diffuse axonal injury is one of the major causes of unconsciousness, profound neurologic deficits and persistent vegetative state after head trauma. In recent years, MR imaging has been gaining popularity as an adjunctive imaging method in patients with DAI. Our study aims to assess the relative diagnostic and prognostic capability of various MRI sequences. Read More

Rev Neurol (Paris) 2018 Jun 19;174(6):358-363. Epub 2018 Apr 19.

Pôle des Neurosciences et de l'Appareil Locomoteur, CHRU de Lille, LIRIC, U995, équipe 3, Université de Lille, 59037 Lille Cedex, France. Electronic address:

Multiple sclerosis (MS) arises in people who have a genetic susceptibility to environmental factors and events, which ultimately trigger the disease. It is thought that peripheral immune cells are mobilized and enter the CNS through the impaired blood-brain barrier in the subarachnoid space, as acute lesions show large numbers of macrophages and CD8+ T cells and, to a lesser extent, CD4+ T cells, B cells and plasma cells. Demyelination is mostly localized to focal lesions in early relapsing-remitting (RR) MS, whereas other areas of white matter appear normal. Read More

J Neurotrauma 2018 Jul 18;35(14):1637-1645. Epub 2018 May 18.

11 Departments of Psychology and Psychiatry and Brain Research Institute , David Geffen School of Medicine, Los Angeles, California.

Diffuse axonal injury contributes to the long-term functional morbidity observed after pediatric moderate/severe traumatic brain injury (msTBI). Whole-brain proton magnetic resonance echo-planar spectroscopic imaging was used to measure the neurometabolite levels in the brain to delineate the course of disruption/repair during the first year post-msTBI. The association between metabolite biomarkers and functional measures (cognitive functioning and corpus callosum [CC] function assessed by interhemispheric transfer time [IHTT] using an event related potential paradigm) was also explored. Read More

Mil Med 2018 03;183(suppl_1):276-286

Applied Physics Laboratory, The Johns Hopkins University, 11100 Johns Hopkins Rd, Laurel, MD 20723.

Combat helmets are expected to protect the warfighter from a variety of blunt, blast, and ballistic threats. Their blunt impact performance is evaluated by measuring linear headform acceleration in drop tower tests, which may be indicative of skull fracture, but not necessarily brain injury. The current study leverages a blunt impact biomechanics model consisting of a head, neck, and helmet with a suspension system to predict how pad stiffness affects both (1) linear acceleration alone and (2) brain tissue response induced by both linear and rotational acceleration. Read More

Emerg Med J 2018 Mar;35(3):148

Emergency Department, Mackay Memorial Hospital, Taipei, Taiwan.

Clinical Introduction: A 58-year-old man sustained injuries due to accidental fall from a height of 5 m onto a solid floor while operating a crane. He was fully conscious without external evidence of head injury when presented to the ED. The patient had multiple fractures involving the fourth, fifth and seventh of the left ribs, left iliac wing and superior ramus of the pelvis, comminuted fracture of the left femur shaft, and an open fracture of the mandible. Read More

J Trauma Acute Care Surg 2018 Jul;85(1):155-159

From the Section of Surgical Sciences, Division of Trauma and Surgical Critical Care, Departments of Surgery and Neurosurgery (S.S.H., M.A.S., J.C.S., M.F.M., M.B.P.), Vanderbilt Brain Institute, Vanderbilt Center for Health Services Research, Vanderbilt University Medical Center, Nashville, Tennessee; College of Medicine (S.S.H.), University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee; Department of Communication Sciences and Disorders (L.D.W.), Oxley College of Health Sciences, The University of Tulsa, Tulsa, Oklahoma; Department of Hearing and Speech Sciences (L.D.W., M.B.P.), Department of Biostatistics (L.W.), Vanderbilt University School of Medicine (D.A.L., J.C.S., A.B., S.P., M.A.D., M.B.P.), Nashville, Tennessee; Department of Emergency Medicine (D.A.L.), San Antonio Military Medical Center, Fort Sam Houston, Texas; Vanderbilt University (M.A.S.); Meharry Medical College, Nashville, Tennessee; (M.A.S.); Department of Radiology and Radiological Sciences (A.B., S.P., M.A.D.), Vanderbilt University Medical Center, Nashville, Tennessee; Department of Neurology (S.M.), University of Massachusetts Medical School, University of Massachusetts Medical Center, Worcester, Massachusetts; and Surgical Service, General Surgery Section, Geriatric Research, Education and Clinical Center Service, Department of Veterans Affairs Medical Center (M.B.P.), Tennessee Valley Health Care System, Nashville, Tennessee.

Background: Determine the prognostic impact of magnetic resonance imaging (MRI)-defined diffuse axonal injury (DAI) after traumatic brain injury (TBI) on functional outcomes, quality of life, and 3-year mortality.

Methods: This retrospective single center cohort included adult trauma patients (age > 17 years) admitted from 2006 to 2012 with TBI. Inclusion criteria were positive head computed tomography with brain MRI within 2 weeks of admission. Read More

World Neurosurg 2018 Apr 6;112:277-283. Epub 2018 Feb 6.

Department of Intensive Care Medicine, Royal Perth Hospital, Perth, Western Australia, Australia.

Background: Diffuse axonal injury (DAI) detected on magnetic resonance imaging (MRI) may be useful to predict outcome after traumatic brain injury (TBI).

Methods: This study compared the ability of the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) prognostic model with DAI on MRI to predict the 18-month neurologic outcome in 56 patients who had required decompressive craniectomy after TBI.

Results: Of the 56 patients included in the study (19 scans occurred within 14 days; median time for all patients 24 days, interquartile range 14-42), 18 (32%) had evidence of DAI on the MRI scans. Read More

Brain Inj 2018 30;32(4):395-402. Epub 2018 Jan 30.

a Department of Neurology , Elisabeth-TweeSteden Hospital , Tilburg , The Netherlands.

Objective: To determine the prognosis of adult patients with traumatic brain injury (TBI) and diffuse axonal injury (DAI).

Methods: Online search (PubMed, Embase and Ovid Science Direct) of articles providing information about outcome in (1) patients with DAI in general, (2) DAI vs. non-DAI, (3) related to magnetic resonance imaging (MRI) classification and (4) related to lesion location/load. Read More

Clin Neuroradiol 2018 Jan 23. Epub 2018 Jan 23.

Department of Radiology, University of Minnesota Medical Center, 420 Delaware St. SE, 55455, Minneapolis, MN, USA.

Background And Purpose: Differentiating Abusive Head Trauma (AHT) from Non-abusive Head trauma (NAHT) has profound clinical prognostic and legal implications, as certain imaging findings can individually be more suggestive of NAHT, while others are more suggestive of AHT. This study was set out to evaluate for an association between the various imaging findings in AHT with outcome.

Material And Methods: Over 7-years, 55 children (age 0-4 years') with head trauma and magnetic resonance imaging (MRI) were included as either: abusive (n = 16), non-abusive (n = 35), or indeterminate (n = 4). Read More

Neuroophthalmology 2017 Aug 9;41(4):215-218. Epub 2017 Mar 9.

Medical Faculty, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain.

Damage to the lateral geniculate body by diffuse axonal injury in brain trauma is uncommon. The authors present the clinical case and fibre tractography using diffusion tensor magnetic resonance imaging of this lesion in a patient presenting with homonymous sectoranopia after a traumatic head injury. Read More

J Neurosurg 2018 Dec;129(6):1588-1597

5Department of Neurosurgery, Tampere University Hospital, Tampere, Finland.

OBJECTIVEThe incidence of intracranial abnormalities after mild traumatic brain injury (TBI) varies widely across studies. This study describes the characteristics of intracranial abnormalities (acute/preexisting) in a large representative sample of head-injured patients who underwent CT imaging in an emergency department.METHODSCT scans were systematically analyzed/coded in the TBI Common Data Elements framework. Read More

J Neurosurg 2018 Nov;129(5):1317-1324

Departments of1Diagnostic Radiology.

OBJECTIVEThe objective of this study was to test the hypothesis that midline (interhemispheric or perimesencephalic) traumatic subarachnoid hemorrhage (tSAH) on initial CT may implicate the same shearing mechanism that underlies severe diffuse axonal injury (DAI).METHODSThe authors enrolled 270 consecutive patients (mean age [± SD] 43 ± 23.3 years) with a history of head trauma who had undergone initial CT within 24 hours and brain MRI within 30 days. Read More

Crit Care Med 2018 Apr;46(4):554-561

Australian New Zealand Intensive Care Research Centre, Melbourne, Australia.

Objective: To determine profiles of serum ubiquitin carboxy-terminal hydrolase L1 and phosphorylated neurofilament heavy-chain, examine whether erythropoietin administration reduce their concentrations, and whether biomarkers discriminate between erythropoietin and placebo treatment groups.

Design: Single-center, prospective observational study.

Setting: A sub-study of the erythropoietin-traumatic brain injury clinical trial, conducted at the Alfred Hospital, Melbourne, Australia. Read More