Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Detection of Traumatic Cerebral Microbleeds by Susceptibility-Weighted Image of MRI

  • Park, Jong-Hwa (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital) ;
  • Park, Seung-Won (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital) ;
  • Kang, Suk-Hyung (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital) ;
  • Nam, Taek-Kyun (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital) ;
  • Min, Byung-Kook (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital) ;
  • Hwang, Sung-Nam (Department of Neurosurgery, College of Medicine, Chung-Ang University, Yongsan Hospital)
  • Published : 2009.10.28
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Abstract

Objective : Susceptibility-weighted image (SWI) is a sensitive magnetic resonance image (MRI) technique to detect cerebral microbleeds (MBLs). which would not be detected by conventional MRI. We performed SWI to detect MBLs and investigated its usefulness in the evaluation of mild traumatic brain injury (MTBI) patients. Methods : From December 2006 to June 2007, twenty-one MTBI patients without any parenchymal hemorrhage on conventional MRI were selected. Forty-two patients without trauma were selected for control group. According to the presence of MBLs, we divided the MTBI group into MBLs positive [SWI (+)] and negative [SWI (-)] group. Regional distribution of MBLs and clinical factors were compared between groups. Results : Fifty-one MBLs appeared in 16 patients of SWI (+) group and 16 MBLs in 10 patients of control group [control (+)], respectively. In SWI (+) group, MBLs were located more frequently in white matters than in deep nucleus different from the control (+) group (p<0.05). Nine patients (56.3%) of SW (+) group had various neurological deficits (disorientation in 4, visual field defect in 2, hearing difficulty in 2 and Parkinson syndrome in 1). Initial Glasgow Coma Scale (GCS)/mean Glasgow Outcome Scale (GOS) were $13.9{\pm}1.5/4.7{\pm}0.8$ and $15.0{\pm}0.0/5.0{\pm}0.0$ in SWI (+) and SWI (-) groups, respectively (p<0.05). Conclusion : Traumatic cerebral MBLs showed characteristic regional distribution, and seemed to have an importance on the initial neurological status and the prognosis. SWI is useful for detection of traumatic cerebral MBLs, and can provide etiologic evidences for some post-traumatic neurologic deficits which were unexplainable with conventional MRI.

Keywords

References

  1. Adams JH, Graham DI, Murray LS, Scott G : Diffuse axonal injury due to nonmissile head injury in humans : An analysis of 45 cases. Ann Neurol 12 : 557-563, 1982 https://doi.org/10.1002/ana.410120610
  2. Gentry LR : Imaging of closed head injury. Radiology 191 : 1-17, 1994
  3. Grados MA, Slomine BS, Gerring JP, Vasa R, Bryan N, Denckla MB : Depth of lesion model in children and adolescents with moderate to severe traumatic brain injury: Use of SPGR MRI to predict severity and outcome. J Neurol Neurosurg Psychiatry 70 : 350-358, 2001 https://doi.org/10.1136/jnnp.70.3.350
  4. Haacke EM : Susceptibility weighted imaging : Google Patents, 2002
  5. Kampfl A, Schmutzhard E, Franz G, Pfausler B, Haring HP, Ulmer H, et al. : Prediction of recovery from post-traumatic vegetative state with cerebral magnetic-resonance imaging. Lancet 351 : 1763-1767, 1998 https://doi.org/10.1016/S0140-6736(97)10301-4
  6. Lee BC, Vo KD, Kido DK, Mukherjee P, Reichenbach J, Lin W, et al. : MR high-resolution blood oxygenation level-dependent venography of occult (low-flow) vascular lesions. AJNR Am J Neuroradiol 20 : 1239-1242, 1999
  7. Levi L, Guilburd JN, Lemberger A, Soustiel JF, Feinsod M : Diffuse axonal injury : analysis of 100 patients with radiological signs. Neurosurgery 27 : 429-432, 1990 https://doi.org/10.1227/00006123-199009000-00015
  8. Levin HS, Amparo E, Eisenberg HM, Williams DH, High WM, McArdle CB, et al. : Magnetic resonance imaging and computerized tomography in relation to the neurobehavioral sequelae of mild and moderate head injuries. J Neurosurg 66 : 706-713, 1987 https://doi.org/10.3171/jns.1987.66.5.0706
  9. Levin HS, Amparo EG, Eisenberg HM, Miner ME, High WM, Ewing-Cobbs L, et al. : Magnetic resonance imaging after closed head injury in children. Neurosurgery 24 : 223-227, 1989 https://doi.org/10.1227/00006123-198902000-00011
  10. Lewine JD, Davis JT, Sloan JH, Kodituwakku PW, Orrison WW : Neuromagnetic assessment of pathophysiologic brain activity induced by minor head trauma. AJNR Am J Neuroradiol 20 : 857-866, 1999
  11. Matsushita T, Anami D, Arioka T, Inoue S, Kariya Y, Fujimoto M, et al. : Basic study of susceptibility-weighted imaging at 1.5t. Acta Med Okayama 62 : 159-168, 2008
  12. Ommaya AK, Goldsmith W, Thibault L : Biomechanics and neuropathology of adult and paediatric head injury. Br J Neurosurg 16 : 220-242, 2002 https://doi.org/10.1080/02688690220148824
  13. Orrison WW, Gentry LR, Stimac GK, Tarrel RM, Espinosa MC, Cobb LC : Blinded comparison of cranial CT and MR in closed head injury evaluation. AJNR Am J Neuroradiol 15 : 351-356, 1994
  14. Reichenbach JR, Venkatesan R, Schillinger DJ, Kido DK, Haacke EM : Small vessels in the human brain : MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology 204 : 272-277, 1997
  15. Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA : Disability caused by minor head injury. Neurosurgery 9 : 221-228, 1981 https://doi.org/10.1227/00006123-198109000-00001
  16. Tong KA, Ashwal S, Holshouser BA, Nickerson JP, Wall CJ, Shutter LA, et al. : Diffuse axonal injury in children : clinical correlation with hemorrhagic lesions. Ann Neurol 56 : 36-50, 2004 https://doi.org/10.1002/ana.20123
  17. Tong KA, Ashwal S, Holshouser BA, Shutter LA, Herigault G, Haacke EM, et al. : Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury : improved detection and initial results. Radiology 227 : 332-339, 2003 https://doi.org/10.1148/radiol.2272020176
  18. Tong KA, Ashwal S, Obenaus A, Nickerson JP, Kido D, Haacke EM : Susceptibility-weighted MR imaging : a review of clinical applications in children. AJNR Am J Neuroradiol 29 : 9-17, 2008 https://doi.org/10.3174/ajnr.A0786

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