TY - JOUR PY - 2019// TI - Patients with mild traumatic brain injury recruited from both hospital and primary care settings: a controlled longitudinal MRI study JO - Journal of neurotrauma A1 - Einarsen, Cathrine A1 - Moen, Kent Gøran A1 - Håberg, Asta Kristine A1 - Eikenes, Live A1 - Kvistad, Kjell Arne A1 - Xu, Jian A1 - Moe, Hans Kristian A1 - Tollefsen, Marie Hexeberg A1 - Vik, Anne A1 - Skandsen, Toril SP - ePub EP - ePub VL - ePub IS - ePub N2 - With an emphasis on traumatic axonal injury (TAI), frequency and evolution of traumatic intracranial lesions on 3T clinical MRI were assessed in a combined hospital and community-based study of patients with mild traumatic brain injury (MTBI). The findings were related to post-concussion symptoms (PCS) at 3 and 12 months. Prospectively, 194 patients (16-60 years) were recruited from the emergency departments at a level 1 trauma center and a municipal outpatient clinic into the Trondheim MTBI follow-up study. MRI was acquired within 72 hours (n=194), at 3 (n=165) and 12 months (n=152) in patients and community controls (n=78). The protocol included T2, diffusion weighted imaging, fluid attenuated inversion recovery (FLAIR) and susceptibility weighted imaging (SWI). PCS was assessed with British Columbia Post Concussion Symptom Inventory in patients and controls. Traumatic lesions were present in 12% on very early MRI, in 5% when CT was negative. TAI was found in 6% and persisted for 12 months on SWI, while TAI lesions on FLAIR disappeared or became less conspicuous on follow-up. PCS occurred in 33% of patients with lesions on MRI and in 19% in patients without lesions at 3 months (p=0.12) and in 21% and 14 % at 12 months (p=0.49). Very early MRI depicted cases of TAI in patients with MTBI with microbleeds persisting for 12 months. Patients with traumatic lesions may have a more protracted recovery, but the study was underpowered to detect significant differences for PCS due to low frequency of trauma-related MRI lesions.

Language: en

LA - en SN - 0897-7151 UR - http://dx.doi.org/10.1089/neu.2018.6360 ID - ref1 ER -