Article

OBJECTIVE: To demonstrate subacute progression of brain atrophy (from 4.5-29mo
postinjury) in moderate to severe traumatic brain injury (TBI) using structural
magnetic resonance imaging (MRI). DESIGN: Within-subjects, repeated-measures
design. SETTING: Inpatient neurorehabilitation program and teaching hospital (MRI
department). PARTICIPANTS: Adults (N=14) with moderate to severe TBI.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Neuroradiologist readings
and volumetric measurements (total brain cerebrospinal fluid and hippocampus) at
4.5 months and 2.5 years postinjury. RESULTS: Ten of 14 patients showed visible
atrophy progression. Significant increase in cerebrospinal fluid (CSF) volume
(t(13)=-4.073, P<.001) and decrease in right and left hippocampal volumes
(t(13)=4.221, P<.001 and t(13)=3.078, P<.005, respectively) were observed from
4.5 months to 2.5 years. Compared with published normative data, patients with
TBI showed significantly more pathologic percent annual volume change for the
hippocampi (t(26)=-3.864, P<.001, right; and t(26)=-2.737, P<.01, left), and a
trend for CSF (t(26)=1.655, P=.059). CONCLUSIONS: This study provides strong MRI
evidence for subacute progression of atrophy, as distinct from early, acute
neurologic changes observed.

Langue : ANGLAIS