Brain imaging after mild head injury or concussion can show lesions associated with traumatic brain injury


Brain imaging soon after mild traumatic brain injury or mild concussion can detect tiny lesions that may eventually provide a target for treating people with mild traumatic brain injury, according to a study released 12 March 2013 and that will be presented at the American Academy of Neurology’s 65th Annual Meeting in San Diego, USA, March 16–23, 2013.

Studies of brain tissue once a person has died have previously shown that different types of lesions are associated with more severe traumatic brain injury. “Our study suggests that imaging may be used to detect and distinguish between these lesions in a living person with mild traumatic brain injury and this finding has important implications for treatment,” said Gunjan Parikh, National Institute of Neurological Disorders and Stroke, University of Maryland R Adams Cowley Shock Trauma Center in Baltimore, (Parikh is also a member of the American Academy of Neurology).

The study involved 256 people (average age of 50) who were admitted to the emergency department at Suburban Hospital in Bethesda and Washington Hospital Center in the District of Columbia after mild head injuries. They underwent magnetic resonance imaging (MRI) brain scans. Of those, 104 had imaging evidence of haemorrhage in the brain (67% reported loss of consciousness, and 65% reported amnesia, or temporary forgetfulness). People with haemorrhages underwent more detailed brain scans with advanced MRI within an average of 17 hours after the injury.

Advanced imaging showed that—of those 104 people with imaging evidence of haemorrhage—20% had microbleed lesions and 33% had tube-shaped linear lesions. Microbleeds were distributed throughout the brain whereas linear lesions, which were found mainly in one area, were more likely to be associated with injury to adjacent brain tissue.

The investigators hypothesised that the linear lesions seen on MRI may represent a type of vascular injury that is seen in brain tissue studies of people with more severe traumatic brain injury. “If that theory is confirmed, it may provide an opportunity to develop treatment strategies for people who have suffered a mild traumatic brain injury,” said Parikh.

The study was supported by the National Institutes of Health (NIH), the National Institute of Neurological Disorders and Stroke and the Center for Neuroscience and Regenerative Medicine at the Uniformed Services University of the Health Sciences, a collaborative effort among NIH, the Department of Defense and Walter Reed National Military Medical Center to develop innovative approaches to brain injury diagnosis and recovery.