Acute cerebral perfusion CT abnormalities associated with posttraumatic amnesia in mild head injury

Posttraumatic amnesia (PTA) is a common symptom following traumatic brain injury. Although this transient memory deficit implies specific impairment of higher brain function, the actual pathophysiology of PTA is not well understood. The aim of this study was to assess regional cerebral hemodynamics with perfusion computed tomography (CT) in patients during PTA following mild head injury compared to patients with resolved PTA. A total of 74 patients with mild head injury without structural abnormalities on a non-contrast CT scan were included and compared to 25 healthy controls. Two patient groups were defined: (1) a PTA group that was scanned during the episode of PTA (n = 34), and (2) a post-PTA group scanned after resolution of PTA (n = 40). The PTA group had significantly reduced cerebral blood flow (CBF) in the frontal grey matter (41.78 [SD 7.4] versus 44.44 [SD 6.2] mL • 100 g⁻¹ • min⁻¹, p = 0.023), and caudate nucleus (44.59 [SD 6.2] versus 47.85 [SD 7.7] mL • 100 g⁻¹ • min⁻¹, p = 0.021), compared to the post-PTA group. Thus in patients with mild head injury, PTA is associated with cerebral perfusion abnormalities in specific cortical and subcortical regions.