Neuroimaging clinics of North America
-
Conventional imaging findings in patients with cerebral concussion and chronic traumatic encephalopathy are absent or subtle in the majority of cases. The most common abnormalities include cerebral volume loss, enlargement of the cavum of the septum pellucidum, cerebral microhemorrhages, and white matter signal abnormalities, all of which have poor sensitivity and specificity. Advanced imaging modalities, such as diffusion tensor imaging (DTI), blood oxygen level dependent functional MR Imaging (BOLD fMRI), MR spectroscopy, perfusion imaging, positron emission tomography (PET), single photon emission computed tomography (SPECT), and magnetoencephalography detect physiologic abnormalities in symptomatic patients and, although currently in the investigation phase, may become useful in the clinical arena.
-
Myelin water imaging (MWI) provides mild traumatic brain injury (mTBI) researchers with a specific myelin biomarker and helps to further elucidate microstructural and microarchitectural changes of white matter after mTBI. Improvement of scanner hardware and software with the implementation of MWI across scanner platforms will likely result in increased research regarding the role of myelin in traumatic brain injury (TBI). Future research should include detailed investigation of myelin between 2 weeks and 2 months after injury, the use of MWI in moderate and severe TBI, and investigation of the role of myelin in chronic TBI.
-
In the United States alone, 1.6 to 3.8 million people have sports-related concussions yearly. The patho-mechanisms of concussions may not be directly measured by conventional neuroimaging; advanced models may be needed to address the shortcomings of the current clinical protocols. Multimodal advanced imaging may provide more accurate diagnosis and predict the clinical course of concussion, assessing the efficacy of existing and emerging multifaceted therapies. In this article, the authors present an overview and pictorial display of conventional and advanced multimodal MR imaging methods that have been applied to identify the brain structures affected in traumatic brain injuries.
-
Neuroimaging Clin. N. Am. · Feb 2018
ReviewDefinition of Traumatic Brain Injury, Neurosurgery, Trauma Orthopedics, Neuroimaging, Psychology, and Psychiatry in Mild Traumatic Brain Injury.
Traumatic brain injury (TBI) disrupts the normal function of the brain. This condition can adversely affect a person's quality of life with cognitive, behavioral, emotional, and physical symptoms that limit interpersonal, social, and occupational functioning. ⋯ Patients with TBI require prompt evaluation and multidisciplinary management. Aside from the type and severity of the TBI, recovery is influenced by individual patient characteristics, social and environmental factors, and access to medical and rehabilitation services.
-
Neuroimaging Clin. N. Am. · Feb 2018
ReviewSusceptibility-Weighted Imaging and Magnetic Resonance Spectroscopy in Concussion.
Although susceptibility-weighted imaging (SWI) studies have suggested an increased number of microhemorrhages in concussion, most show no significant differences compared with controls. There have been mixed results on using SWI to predict neurologic outcomes. ⋯ Applications in individual patients are impeded by conflicting data and lack of consensus on an optimal protocol. Therefore, currently MRS has most utility in group-level comparisons designed to reveal the pathophysiology of concussion.