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Imaging Concussion

Brandon S Baksh, Namita Sinha, Afshin Salehi, Rowland H Han, Brandon A Miller, Sonika Dahiya, Karen M Gauvain, David D Limbrick
BACKGROUND: Choroid plexus carcinoma (CPC) is a rare, malignant tumor occurring more commonly in children than adults. This case report describes the clinical course of a 3-year-old boy with a rare case of metastatic CPC with a novel TP53 mutation. CASE DESCRIPTION: A 3-year-old boy presented with post-concussive symptoms after a fall. Computed tomography and magnetic resonance imaging revealed lesions in the suprasellar cistern, left lateral ventricle and cauda equina...
August 9, 2018: World Neurosurgery
Barry Willer, Robert Zivadinov, Mohammad N Haider, Jeffrey C Miecznikowski, John J Leddy
OBJECTIVE: To provide an overview of 3 studies of the same population of retired professional contact sport athletes compared with age-matched noncontact sport athlete controls on cognition, executive function, behavior, and advanced brain imaging. SETTING: University Concussion Management Clinic. PARTICIPANTS: Twenty-two retired professional hockey and football athletes (average age 56 years) and 21 age-matched noncontact sport athlete controls...
August 3, 2018: Journal of Head Trauma Rehabilitation
Roh-Eul Yoo, Seung Hong Choi, Byung-Mo Oh, Sang Do Shin, Eun Jung Lee, Dong Jae Shin, Sang Won Jo, Koung Mi Kang, Tae Jin Yun, Ji-Hoon Kim, Chul-Ho Sohn
OBJECTIVES: To explore the utility of dynamic contrast-enhanced (DCE) MR imaging for quantitative analysis of blood-brain barrier disruption in mild traumatic brain injury (mTBI) patients with post-concussion syndrome (PCS). METHODS: Forty-four consecutive patients with PCS after mTBI and 32 controls were included in this retrospective study. Ktrans and ve from DCE MR imaging were analyzed at contrast-enhancing lesions, T2 hyperintense white matter (WM) lesions, normal-appearing white matter (NAWM), and predilection sites for diffuse axonal injury (LocationDAI )...
July 31, 2018: European Radiology
Todd G Rubin, Eva Catenaccio, Roman Fleysher, Liane E Hunter, Naomi Lubin, Walter F Stewart, Mimi Kim, Richard B Lipton, Michael L Lipton
Purpose To examine the role of sex in abnormal white matter microstructure after soccer heading as identified by using the diffusion-tensor imaging (DTI) metric fractional anisotropy (FA). Materials and Methods In this prospective cross-sectional study, 98 individuals who were enrolled in a larger prospective study of amateur soccer players (from 2013 to 2016) were matched 1:1 for age and history of soccer heading in the prior 12 months. Among the subjects, 49 men (mean age, 25.7 years; range, 18-50 years) and 49 women (mean age, 25...
July 31, 2018: Radiology
Milan Toma, Paul D H Nguyen
PRIMARY OBJECTIVE: Closed brain injuries are a common danger in contact sports and motorized vehicular collisions. Mild closed brain injuries, such as concussions, are not easily visualized by computed imaging or scans. Having a comprehensive head/brain model and using fluid-structure interaction (FSI) simulations enable us to see the exact movement of the cerebrospinal fluid (CSF) under such conditions and to identify the areas of brain most affected. RESEARCH DESIGN: The presented work is based on the first FSI model capable of simulating the interaction between the CSF flow and brain...
July 30, 2018: Brain Injury: [BI]
Nan-Jie Gong, Samuel Kuzminski, Michael Clark, Melissa Fraser, Mark Sundman, Kevin Guskiewicz, Jeffrey R Petrella, Chunlei Liu
OBJECTIVES: To probe microstructural changes that are associated with subconcussive head impact exposure in deep and cortical gray matter of high school football players over a single season. METHODS: Players underwent diffusion kurtosis imaging (DKI) and quantitative susceptibility mapping (QSM) scans. Head impact data was recorded. Association between parametric changes and frequency of frontal head impact was assessed. RESULTS: In deep gray matter, significant decreases in mean kurtosis (MK) and increases in mean diffusivity (MD) over the season were observed in the thalamus and putamen...
July 23, 2018: Neurobiology of Disease
Erin D Bigler, Chris Finuf, Tracy J Abildskov, Naomi J Goodrich-Hunsaker, Jo Ann Petrie, Dawn-Marie Wood, John R Hesselink, Elisabeth A Wilde, Jeffrey E Max
This investigation explored whether differences in cortical thickness could be detected in children who sustained a mild traumatic brain injury (mTBI) compared to those with orthopedic injury (OI) and whether cortical thickness related parental reporting of symptoms. To achieve this objective, FreeSurfer®-based cortical thickness measures were obtained in 330 children, 8 to 15 years of age, with either a history of mTBI or OI. Imaging was performed in all participants with the same 3 Tesla MRI scanner at six-months post-injury, where a parent-rated Post-Concussion Symptom Inventory (PCSI) was also obtained...
July 21, 2018: International Journal of Psychophysiology
Priya Santhanam, Theresa Teslovich, Steffanie H Wilson, Ping-Hong Yeh, Terrence R Oakes, Lindell Weaver
Post-traumatic stress disorder (PTSD) is commonly observed in military service members with mild traumatic brain injury (mTBI); however, the relationship between mTBI and PTSD is complex and not well-understood. The present study aims to elucidate a link between the degree of alteration in limbic system-related white matter tracts and PTSD symptoms in an mTBI population. Diffusion tensor imaging with probabilistic tractography of the fronto-limbic pathways revealed decreased white matter integrity in the uncinate fasciculus in those with comorbid mTBI and PTSD (n=34), relative to those with only mTBI (n=35)...
July 24, 2018: Journal of Neurotrauma
Thomas A Daniel, Kyle M Townsend, Yun Wang, David S Martin, Jeffrey S Katz, Gopikrishna Deshpande
While social and behavioral effects of violence in the media have been studied extensively, much less is known about how sports affect perceptions of violence. The current study examined neurofunctional differences between fans and non-fans of North American football (a contact sport) while viewing violent imagery. Participants viewed images of violence in both football and non-football settings while high-resolution functional magnetic resonance imaging (fMRI) data were acquired from their brains. Neurological activation was compared between these violence types and between groups...
2018: Frontiers in Public Health
Natalie S Dailey, Ryan Smith, Sahil Bajaj, Anna Alkozei, Melissa K Gottschlich, Adam C Raikes, Brieann C Satterfield, William D S Killgore
Mild traumatic brain injury (mTBI) remains the most commonly reported head injury in the United States, and is associated with a wide range of post-concussive symptoms including physical, cognitive and affective impairments. Elevated aggression has been documented in mTBI; however, the neural mechanisms associated with aggression at the chronic stage of recovery remain poorly understood. In the present study, we investigated the association between white matter integrity and aggression in mTBI using diffusion tensor imaging (DTI)...
2018: Frontiers in Behavioral Neuroscience
James Bouley, David Y Chung, Cenk Y Ayata, Robert H Brown, Nils Henninger
Cortical spreading depression (CSD) has been described after moderate-to-severe traumatic brain injury (TBI). However, it is uncertain whether CSD occurs after mild, concussive TBI and whether it relates to brain pathology and functional outcome. Male C57BL6/J mice (n=62) were subjected to closed head TBI with a 25g weight (n=11), 50g weight (n=45), or sham injury (n=6). Laser Doppler flowmetry and optical intrinsic signal imaging were used to determine cerebral blood flow dynamics after concussive CSD. Functional deficits were assessed at baseline, 2 h, 24 h, and 48 h...
July 12, 2018: Journal of Neurotrauma
Melissa A Lancaster, Timothy B Meier, Daniel V Olson, Michael A McCrea, Lindsay D Nelson, L Tugan Muftuler
Recent studies demonstrated evidence of physiological changes in the brain following sport-related concussion (SRC) that persisted beyond the point at which athletes achieved full symptom recovery. Diffusion MRI techniques have been used to study brain white matter (WM) changes following SRC; however, longitudinal studies that follow injured athletes from the acute to chronic stages of injury are sparse. The current study explores potential persisting effects of the injury, which serves as a follow-up to our previous work that reported WM changes in the acute and subacute phase of SRC recovery...
July 2, 2018: Human Brain Mapping
Christine L MacDonald, Jason Barber, Jason Wright, David Coppel, Nina De Lacy, Steve Ottinger, Suzanne Peck, Chris Panks, Samantha Sun, Kody Zalewski, Nancy Temkin
This study longitudinally assessed 10-14-year-old patients with sports and recreational concussion (n=22) who remained symptomatic 3-4 weeks post-injury compared to typically developing controls (n=24). Examination by multimodal MRI and multidomain clinical outcome measures was completed at 1-month and 6-months post-injury. Concussion patients showed evidence of improvement by 6-month follow up in domains of cognitive function while measures of psychological health were less resolved with patients exhibiting sustained symptoms of depression, behavior impairment, and concussion symptoms...
June 14, 2018: Journal of Neurotrauma
K M Koch, T B Meier, R Karr, A S Nencka, L T Muftuler, M McCrea
BACKGROUND AND PURPOSE: Quantitative susceptibility mapping using MR imaging can assess changes in brain tissue structure and composition. This report presents preliminary results demonstrating changes in tissue magnetic susceptibility after sports-related concussion. MATERIALS AND METHODS: Longitudinal quantitative susceptibility mapping metrics were produced from imaging data acquired from cohorts of concussed and control football athletes. One hundred thirty-six quantitative susceptibility mapping datasets were analyzed across 3 separate visits (24 hours after injury, 8 days postinjury, and 6 months postinjury)...
July 2018: AJNR. American Journal of Neuroradiology
Julia Schmidt, Cristina Rubino, Lara A Boyd, Naznin Virji-Babul
BACKGROUND AND PURPOSE: Concussion is a major public health concern and one of the least understood neurological injuries. Children and youth are disproportionally affected by concussion, and once injured, take longer to recover. Current guidelines recommend a period of physical and cognitive rest with a gradual progressive return to activity. Although there is limited high-quality evidence (eg, randomized controlled trials) on the benefit of physical activity and exercise after concussion, most studies report a positive impact of exercise in facilitating recovery after concussion...
July 2018: Journal of Neurologic Physical Therapy: JNPT
Claire B Rosen, Diego D Luy, Molly R Deane, Thomas M Scalea, Deborah M Stein
Background: Routine repeat cranial CT (RHCT) is standard of care for CT-verified traumatic brain injury (TBI). Despite mixed evidence, those with mild TBI are subject to radiation and expense from serial CT scans. Thus, we investigated the necessity and utility of RHCT for patients with mild TBI. We hypothesized that repeat head CT in these patients would not alter patient care or outcomes. Methods: We retrospectively studied patients suffering from mild TBI (Glasgow Coma Scale (GCS) score 13-15) and treated at the R Adams Cowley Shock Trauma Center from November 2014 through January 2015...
2018: Trauma surgery & acute care open
Patrick K O'Callaghan, Elliott Carter, Zeke Walton, Russell Chapin, Evelyn Bruner
CASE: A 19-year-old woman presented with a 3-month history of an enlarging lesion on the proximal aspect of the femur. After imaging studies and a biopsy had been performed, the mass was determined to represent heterotopic ossification (HO). The only known risk factor was a history of concussion. The mass was resected and, as of the 12-month follow-up, had not recurred. CONCLUSION: HO is a potentially serious complication of ossification in soft tissues that can develop secondary to several disease states; it commonly occurs following traumatic brain injury...
April 2018: JBJS Case Connector
Alicia Meconi, Ryan C Wortman, David K Wright, Katie J Neale, Melissa Clarkson, Sandy R Shultz, Brian R Christie
Repeated concussion is becoming increasingly recognized as a serious public health concern around the world. Moreover, there is a greater awareness amongst health professionals of the potential for repeated pediatric concussions to detrimentally alter the structure and function of the developing brain. To better study this issue, we developed an awake closed head injury (ACHI) model that enabled repeated concussions to be performed reliably and reproducibly in juvenile rats. A neurological assessment protocol (NAP) score was generated immediately after each ACHI to help quantify the cumulative effects of repeated injury on level of consciousness, and basic motor and reflexive capacity...
2018: PloS One
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
Heather S Spader, Douglas C Dean, W Curt LaFrance, Neha P Raukar, G Rees Cosgrove, Stephanie A Eyerly-Webb, Anna Ellermeier, Stephen Correia, Sean C L Deoni, Jeffrey Rogg
OBJECTIVE Mild traumatic brain injury (mTBI) in athletes, including concussion, is increasingly being found to have long-term sequelae. Current imaging techniques have not been able to identify early damage caused by mTBI that is predictive of long-term symptoms or chronic traumatic encephalopathy. In this preliminary feasibility study, the authors investigated the use of an emerging magnetic resonance imaging (MRI) technique, multicomponent driven equilibrium single pulse observation of T1 and T2 (mcDESPOT), in visualizing acute and chronic white matter changes after mTBI in collegiate football and rugby players...
May 1, 2018: Journal of Neurosurgery
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