Features of diagnostics of repeated mild traumatic brain injuries according to magnetic resonance imaging | Ukrainian Medical Journal

Muravska O.M.

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Features of diagnostics of repeated mild traumatic brain injuries according to magnetic resonance imaging

Features of diagnostics of repeated mild traumatic brain injuries according to magnetic resonance imaging

March 7, 2025

136

Neurology and Psychiatry

Muravska O.M.

УДК: 616.831-001-073.756.8-073.8:796.83

DOI: 10.32471/umj.1680-3051.263778

Keywords :

magnetic resonance imaging,

repeated traumatic brain injury

Specialities :

Neurology and Psychiatry

Resume

The aim is to determine the features of MRI changes in patients with repeated mild traumatic brain injury (TBI).

Material and methods. The study was conducted during 2020–2024 in people with a history of repeated mild TBI. The total number of subjects was 174, including 138 men (79.31%) and 36 women (20.69%). The age of people who suffered repeated TBI ranged from 17 to 60 years, with an average of 33.17±2.39 years. The number of repeated TBI (concussion and mild brain contusion) in one patient ranged from two to five. All patients were examined in the remote period of TBI. The control group consisted of 30 people aged 18 to 50 years (mean age 33.11±3.09) with no history of TBI. MRI of the brain was performed on a 1.5 Tesla magnetic field induction device. The MRI examination protocol included standard sequences and sequences allowing to obtain additional information when visualizing complex anatomical areas. The MRI scan examined the presence of structural changes in the brain, foci of altered MR signal, signs of cerebrospinal fluid disturbance, changes in the cerebrospinal fluid and subarachnoid spaces (SS), their prevalence and severity.

Results. According to the results of the neuroimaging study of the brain and cerebrospinal fluid, the size of the ventricular system in both the main and control groups was within normal limits. Patients with repeated mild TBI were characterized by a significant (p<0.01) increase in the width of the lateral ventricles (LV) on both sides, the width of the third ventricle, and the width of the cavum septum pellucidum (CSP) compared with the control group. The median structure index in patients with repeated mild TBI was lower than in the control group. Changes in the brain MRI in the main group were observed both in the cerebrospinal fluid and cerebral substance. The asymmetry of the LV, arachnoid cyst and pineal cyst, foci (subcortical, periventricular, cerebellar) were found only in patients with repeated TBI. There was a significantly higher frequency of dilatation of the CSP (p<0.01), dilatation of the convexal SS (p<0.05) in the main group compared to the control group. In the group of patients with repeated mild TBI, compared to the control group, diffuse expansion of the SS was also dominant, but this statement is not statistically significant. The MRI picture of the brain without changes in the main group was found in 43.10% of cases, while in the control group — 86.67%.

Conclusion. In patients with repeated mild TBI, there was a significant increase in the width of the LV on both sides, III ventricle and CSP, and these changes were more pronounced in men. Asymmetry of the LV, arachnoid and pineal cysts, foci in the subcortical, periventricular and cerebellar regions were observed only in patients of the main group. The MRI picture of the brain without changes was more common in women and in the youngest age group (17–24 years).

References

1. Huovinen A., Marinkovic I., Isokuortti H. et al. (2022) Return to work after mild traumatic brain injury: association with positive CT and MRI findings. Acta Neurochir. (Wien), 164(7): 1707–1717. doi: 10.1007/s00701-022-05244-4.
2. Vedaei F., Mashhadi N., Zabrecky G. et al. (2023) Identification of chronic mild traumatic brain injury using resting state functional MRI and machine learning techniques. Front. Neurosci., 16: 1099560. doi: 10.3389/fnins.2022.1099560.
3. Bischof G.N., Cross D.J. (2023) Brain Trauma Imaging. J. Nucl. Med., 64(1): 20–29. doi: 10.2967/jnumed.121.263293.
4. Liu Y., Lu L., Li F. et al. (2022) Neuropathological Mechanisms of Mild Traumatic Brain Injury: A Perspective From Multimodal Magnetic Resonance Imaging. Front. Neurosci., 16: 923662. doi: 10.3389/fnins.2022.923662.
5. Lunkova E., Guberman G.I., Ptito A. et al. (2021) Noninvasive magnetic resonance imaging techniques in mild traumatic brain injury research and diagnosis. Hum. Brain Mapp., 42(16): 5477–5494. doi: 10.1002/hbm.25630.
6. Allen C.M., Halsey L., Topcu G. et al. (2021) Magnetoencephalography abnormalities in adult mild traumatic brain injury: A systematic review. Neuroimage Clin., 31: 102697. doi: 10.1016/j.nicl.2021.102697.
7. Bielanin J.P., Metwally S.A.H., Paruchuri S.S. et al. (2024) An overview of mild traumatic brain injuries and emerging therapeutic targets. Neurochem. Int., 172: 105655. doi: 10.1016/j.neuint.2023.105655.
8. Lefevre-Dognin C., Cogné M., Perdrieau V. et al. (2021) Definition and epidemiology of mild traumatic brain injury. Neurochirurgie, 67(3): 218–221. doi: 10.1016/j.neuchi.2020.02.002.
9. van den Brink H., Doubal F.N., Duering M. (2023) Advanced MRI in cerebral small vessel disease. Int. J. Stroke, 18(1): 28–35. doi: 10.1177/17474930221091879.
10. Ware J.B., Sandsmark D.K. (2023) Imaging Approach to Concussion. Neuroimaging Clin N Am., 33(2): 261–269. doi: 10.1016/j.nic.2023.01.002.