DOI QR코드

DOI QR Code

Radiologic Determination of Corpus Callosum Injury in Patients with Mild Traumatic Brain Injury and Associated Clinical Characteristics

  • Kim, Dong Shin (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Choi, Hyuk Jai (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Yang, Jin Seo (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Cho, Yong Jun (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kang, Suk Hyung (Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University)
  • Received : 2014.10.31
  • Accepted : 2015.06.10
  • Published : 2015.08.28

Abstract

Objective : To investigate the incidence of corpus callosum injury (CCI) in patients with mild traumatic brain injury (TBI) using brain MRI. We also performed a review of the clinical characteristics associated with this injury. Methods : A total of 356 patients in the study were diagnosed with TBI, with 94 patients classified as having mild TBI. We included patients with mild TBI for further evaluation if they had normal findings via brain computed tomography (CT) scans and also underwent brain MRI in the acute phase following trauma. As assessed by brain MRI, CCI was defined as a high-signal lesion in T2 sagittal images and a corresponding low-signal lesion as determined by axial gradient echo (GRE) imaging. Based on these criteria, we divided patients into two groups for further analysis : Group I (TBI patients with CCI) and Group II (TBI patients without CCI). Results : A total of 56 patients were enrolled in this study (including 16 patients in Group I and 40 patients in Group II). Analysis of clinical symptoms revealed a significant difference in headache severity between groups. Over 50% of patients in Group I experienced prolonged neurological symptoms including dizziness and gait disturbance and were more common in Group I than Group II (dizziness : 37 and 12% in Groups I and II, respectively; gait disturbance : 12 and 0% in Groups I and II, respectively). Conclusion : The incidence of CCI in patients with mild TBI was approximately 29%. We suggest that brain MRI is a useful method to reveal the cause of persistent symptoms and predict clinical prognosis.

Keywords

References

  1. Calvi MR, Beretta L, Dell'Acqua A, Anzalone N, Licini G, Gemma M : Early prognosis after severe traumatic brain injury with minor or absent computed tomography scan lesions. J Trauma 70 : 447-451, 2011 https://doi.org/10.1097/TA.0b013e3182095e14
  2. Cassidy JD, Carroll LJ, Peloso PM, Borg J, von Holst H, Holm L, et al. : Incidence, risk factors and prevention of mild traumatic brain injury : results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med (43 Suppl) : 28-60, 2004
  3. Chao YP, Cho KH, Yeh CH, Chou KH, Chen JH, Lin CP : Probabilistic topography of human corpus callosum using cytoarchitectural parcellation and high angular resolution diffusion imaging tractography. Hum Brain Mapp 30 : 3172-3187, 2009 https://doi.org/10.1002/hbm.20739
  4. Chew BG, Spearman CM, Quigley MR, Wilberger JE : The prognostic significance of traumatic brainstem injury detected on T2-weighted MRI. J Neurosurg 117 : 722-728, 2012 https://doi.org/10.3171/2012.6.JNS111736
  5. de Laat KF, Tuladhar AM, van Norden AG, Norris DG, Zwiers MP, de Leeuw FE : Loss of white matter integrity is associated with gait disorders in cerebral small vessel disease. Brain 134 (Pt 1) : 73-83, 2011 https://doi.org/10.1093/brain/awq343
  6. Evans RW : The postconcussion syndrome and the sequelae of mild head injury. Neurol Clin 10 : 815-847, 1992 https://doi.org/10.1016/S0733-8619(18)30182-8
  7. Firsching R, Woischneck D, Klein S, Reissberg S, Dohring W, Peters B : Classification of severe head injury based on magnetic resonance imaging. Acta Neurochir (Wien) 143 : 263-271, 2001 https://doi.org/10.1007/s007010170106
  8. Gallo A, Rovaris M, Riva R, Ghezzi A, Benedetti B, Martinelli V, et al. : Diffusion-tensor magnetic resonance imaging detects normal-appearing white matter damage unrelated to short-term disease activity in patients at the earliest clinical stage of multiple sclerosis. Arch Neurol 62 : 803-808, 2005 https://doi.org/10.1001/archneur.62.5.803
  9. Gentry LR, Godersky JC, Thompson B : MR imaging of head trauma : review of the distribution and radiopathologic features of traumatic lesions. AJR Am J Roentgenol 150 : 663-672, 1988 https://doi.org/10.2214/ajr.150.3.663
  10. Gentry LR, Thompson B, Godersky JC : Trauma to the corpus callosum : MR features. AJNR Am J Neuroradiol 9 : 1129-1138, 1988
  11. Godersky JC, Gentry LR, Tranel D, Dyste GN, Danks KR : Magnetic resonance imaging and neurobehavioural outcome in traumatic brain injury. Acta Neurochir Suppl (Wien) 51 : 311-314, 1990
  12. Gorrie C, Duflou J, Brown J, Gibson T, Waite PM : Extent and distribution of vascular brain injury in pediatric road fatalities. J Neurotrauma 18 : 849-860, 2001 https://doi.org/10.1089/089771501750451776
  13. Hofer S, Frahm J : Topography of the human corpus callosum revisited-- comprehensive fiber tractography using diffusion tensor magnetic resonance imaging. Neuroimage 32 : 989-994, 2006 https://doi.org/10.1016/j.neuroimage.2006.05.044
  14. Jennett B, Snoek J, Bond MR, Brooks N : Disability after severe head injury : observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry 44 : 285-293, 1981 https://doi.org/10.1136/jnnp.44.4.285
  15. Kampfl A, Franz G, Aichner F, Pfausler B, Haring HP, Felber S, et al. : The persistent vegetative state after closed head injury : clinical and magnetic resonance imaging findings in 42 patients. J Neurosurg 88 : 809-816, 1998 https://doi.org/10.3171/jns.1998.88.5.0809
  16. Lagares A, Ramos A, Perez-Nunez A, Ballenilla F, Alday R, Gomez PA, et al. : The role of MR imaging in assessing prognosis after severe and moderate head injury. Acta Neurochir (Wien) 151 : 341-356, 2009 https://doi.org/10.1007/s00701-009-0194-8
  17. Matsukawa H, Shinoda M, Fujii M, Takahashi O, Yamamoto D, Murakata A, et al. : Genu of corpus callosum as a prognostic factor in diffuse axonal injury. J Neurosurg 115 : 1019-1024, 2011 https://doi.org/10.3171/2011.6.JNS11513
  18. Rutgers DR, Fillard P, Paradot G, Tadié M, Lasjaunias P, Ducreux D : Diffusion tensor imaging characteristics of the corpus callosum in mild, moderate, and severe traumatic brain injury. AJNR Am J Neuroradiol 29 : 1730-1735, 2008 https://doi.org/10.3174/ajnr.A1213
  19. Ryberg C, Rostrup E, Stegmann MB, Barkhof F, Scheltens P, van Straaten EC, et al. : Clinical significance of corpus callosum atrophy in a mixed elderly population. Neurobiol Aging 28 : 955-963, 2007 https://doi.org/10.1016/j.neurobiolaging.2006.04.008
  20. Shigemori M, Kojyo N, Yuge T, Tokutomi T, Nakashima H, Kuramoto S : Massive traumatic haematoma of the corpus callosum. Acta Neurochir (Wien) 81 : 36-39, 1986 https://doi.org/10.1007/BF01456262
  21. Tokutomi T, Hirohata M, Miyagi T, Abe T, Shigemori M : Posttraumatic edema in the corpus callosum shown by MRI. Acta Neurochir Suppl 70 : 80-83, 1997
  22. Viano DC, Casson IR, Pellman EJ, Zhang L, King AI, Yang KH : Concussion in professional football : brain responses by finite element analysis : part 9. Neurosurgery 57 : 891-916; discussion 891-916, 2005 https://doi.org/10.1227/01.NEU.0000186950.54075.3B
  23. Witelson SF : Hand and sex differences in the isthmus and genu of the human corpus callosum. A postmortem morphological study. Brain 112 (Pt 3) : 799-835, 1989 https://doi.org/10.1093/brain/112.3.799
  24. Yanagawa Y, Sakamoto T : Significance of minor traumatic lesions in focal head injuries. J Clin Neurosci 18 : 520-523, 2011 https://doi.org/10.1016/j.jocn.2010.07.133
  25. Yasuno F, Matsuoka K, Kitamura S, Kiuchi K, Kosaka J, Okada K, et al. : Decision-making deficit of a patient with axonal damage after traumatic brain injury. Brain Cogn 84 : 63-68, 2014 https://doi.org/10.1016/j.bandc.2013.11.005
  26. Yuan F, Ding J, Chen H, Guo Y, Wang G, Gao WW, et al. : Predicting outcomes after traumatic brain injury : the development and validation of prognostic models based on admission characteristics. J Trauma Acute Care Surg 73 : 137-145, 2012 https://doi.org/10.1097/TA.0b013e31824b00ac

Cited by

  1. Differences in corpus callosum injury between cerebral concussion and diffuse axonal injury vol.98, pp.41, 2015, https://doi.org/10.1097/md.0000000000017467
  2. Traumatic Brain Injury Results in Dynamic Brain Structure Changes Leading to Acute and Chronic Motor Function Deficits in a Pediatric Piglet Model vol.36, pp.20, 2015, https://doi.org/10.1089/neu.2018.6303
  3. Boomerang-shaped hemorrhage of the splenium of corpus callosum after mild brain injury: an unusual case of delayed hematoma vol.63, pp.5, 2015, https://doi.org/10.23736/s0390-5616.17.04270-9
  4. Dynamic changes in white matter following traumatic brain injury and how diffuse axonal injury relates to cognitive domain vol.35, pp.3, 2015, https://doi.org/10.1080/02699052.2020.1859615