Advanced MRI offers detailed info on brain lesions in mTBI patients

MRI soon after a mild concussion, or mild traumatic brain injury (mTBI), can detect small lesions and may help refine treatment for people with mTBI, according to research that will be presented at the American Academy of Neurology annual meeting in San Diego, March 16 to 23.

Previous studies have shown that different types of lesions are associated with more severe TBI, but this research focused on the brain tissue of patients after death.

“Our study suggests that imaging may be used to detect and distinguish between these lesions in a living person with mTBI and this finding has important implications for treatment,” Gunjan Parikh, MD, of the National Institute of Neurological Disorders and Stroke and the University of Maryland R. Adams Cowley Shock Trauma Center in Baltimore, said in a release.

Parikh and colleagues studied a cohort of 256 people admitted to the emergency departments at Suburban Hospital in Bethesda, Md., and Washington Hospital Center in D.C. following mild head injuries. Sixty-seven percent reported loss of consciousness, and 65 percent reported amnesia or temporary forgetfulness.

After undergoing MR imaging, 104 patients showed imaging evidence of hemorrhages, and these patients underwent more detailed brain scans—including T2-weighted MRI and diffusion weighted imaging—within an average of 17 hours after the injury.

This advanced imaging revealed that 20 percent of the patients with evidence of hemorrhage had microbleed lesions and one-third had tube-shaped linear lesions, according to the researchers. Microbleeds were found throughout the brain, but linear lesions were found mainly in a single area and were more likely to be associated with injury to adjacent brain tissue.

The researchers hypothesized that linear lesions seen on MRI may represent a type of vascular injury seen in brain tissue studies of people with more severe TBI. If confirmed, this information could help develop treatment strategies for people who have suffered mTBI, according to Parikh.