Articles: traumatic-brain-injuries.
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Neuroimaging Clin. N. Am. · May 2023
ReviewThe Current State of Functional MR Imaging for Trauma Prognostication.
In this review, we discuss the basics of functional MRI (fMRI) techniques including task-based and resting state fMRI, and overview the major findings in patients with traumatic brain injury. We summarize the studies that have longitudinally evaluated the changes in brain connectivity and task-related activation in trauma patients during different phases of trauma. We discuss how these data may potentially be used for prognostication, treatment planning, or monitoring and management of trauma patients.
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Cerebrovascular reactivity (CVR) reflects the change in cerebral blood flow in response to vasodilatory stimuli enabling assessment of the health of the cerebral vasculature. Recent advances in the quantitative delivery of CO2 stimuli with computer-controlled sequential gas delivery have enabled mapping of the speed and magnitude of response to flow stimuli. These CVR advances when applied to patients with acute concussion have unexpectedly shown faster speed and greater magnitude of responses unseen in other diseases that typically show the opposite effects. The strength of the CVR alterations have diagnostic potential in single subjects with AUC values in the 0.90-0.94 range.
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Neuroimaging Clin. N. Am. · May 2023
ReviewCurrent State of Diffusion-Weighted Imaging and Diffusion Tensor Imaging for Traumatic Brain Injury Prognostication.
Advanced imaging techniques are needed to assist in providing a prognosis for patients with traumatic brain injury (TBI), particularly mild TBI (mTBI). Diffusion tensor imaging (DTI) is one promising advanced imaging technique, but has shown variable results in patients with TBI and is not without limitations, especially when considering individual patients. Efforts to resolve these limitations are being explored and include developing advanced diffusion techniques, creating a normative database, improving study design, and testing machine learning algorithms. This article will review the fundamentals of DTI, providing an overview of the current state of its utility in evaluating and providing prognosis in patients with TBI.
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Review Meta Analysis
Duret brainstem hemorrhage following trans-tentorial descending brain herniation: a systematic review and meta-analysis.
Historically, the occurrence of hemorrhage in the brainstem after an episode of supratentorial intracranial hypertension was described by Henri Duret in 1878. Nevertheless, to date the eponym Duret brainstem hemorrhage (DBH) lacks systematic evidence regarding its epidemiology, pathophysiology, clinical and radiologic presentation, and outcome. ⋯ Unlike its historical description, DBH appears as a focal hematoma in the upper brainstem caused by the rupture of anteromedial basilar artery perforators after sudden downward displacement of the brainstem, regardless of its cause.