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Open Access 01-08-2011 | Diagnostic Neuroradiology

Microstructural brain injury in post-concussion syndrome after minor head injury

Authors: Marion Smits, Gavin C. Houston, Diederik W. J. Dippel, Piotr A. Wielopolski, Meike W. Vernooij, Peter J. Koudstaal, M. G. Myriam Hunink, Aad van der Lugt

Published in: Neuroradiology | Issue 8/2011

Abstract

Introduction

After minor head injury (MHI), post-concussive symptoms commonly occur. The purpose of this study was to correlate the severity of post-concussive symptoms in MHI patients with MRI measures of microstructural brain injury, namely mean diffusivity (MD) and fractional anisotropy (FA), as well as the presence of microhaemorrhages.

Methods

Twenty MHI patients and 12 healthy controls were scanned at 3 T using diffusion tensor imaging (DTI) and high-resolution gradient recalled echo (HRGRE) T2*-weighted sequences. One patient was excluded from the analysis because of bilateral subdural haematomas. DTI data were preprocessed using Tract Based Spatial Statistics. The resulting MD and FA images were correlated with the severity of post-concussive symptoms evaluated with the Rivermead Postconcussion Symptoms Questionnaire. The number and location of microhaemorrhages were assessed on the HRGRE T2*-weighted images.

Results

Comparing patients with controls, there were no differences in MD. FA was decreased in the right temporal subcortical white matter. MD was increased in association with the severity of post-concussive symptoms in the inferior fronto-occipital fasciculus (IFO), the inferior longitudinal fasciculus and the superior longitudinal fasciculus. FA was reduced in association with the severity of post-concussive symptoms in the uncinate fasciculus, the IFO, the internal capsule and the corpus callosum, as well as in the parietal and frontal subcortical white matter. Microhaemorrhages were observed in one patient only.

Conclusions

The severity of post-concussive symptoms after MHI was significantly correlated with a reduction of white matter integrity, providing evidence of microstructural brain injury as a neuropathological substrate of the post-concussion syndrome.

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Title: Microstructural brain injury in post-concussion syndrome after minor head injury
Authors: Marion Smits
Gavin C. Houston
Diederik W. J. Dippel
Piotr A. Wielopolski
Meike W. Vernooij
Peter J. Koudstaal
M. G. Myriam Hunink
Aad van der Lugt
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 8/2011
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-010-0774-6

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Springer Medicine

Microstructural brain injury in post-concussion syndrome after minor head injury

Abstract

Introduction

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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