Findings from Structural MR Imaging in Military Traumatic Brain Injury

Area of Science:

• Neuroradiology
• Neuroimaging
• Military Medicine

Background:

• Chronic mild traumatic brain injury (TBI) in military service members is frequently associated with blast exposure.
• Understanding the long-term neuroradiological consequences of mild TBI is crucial for effective management.

Purpose of the Study:

• To characterize initial neuroradiology findings in military personnel with chronic mild TBI from blast.
• To utilize an integrated magnetic resonance (MR) imaging protocol for comprehensive assessment.

Main Methods:

• A cohort of 834 military service members with TBI and 42 controls underwent 3T MR imaging.
• Structural imaging included T1-weighted, T2-weighted, FLAIR, and susceptibility-weighted sequences.
• Neuroradiologists evaluated findings using modified TBI common data elements (CDEs).

Main Results:

• The majority of TBI participants had chronic (mean 1381 days post-injury) and mild TBI (92%).
• White matter T2-weighted hyperintensities were common (51.8%), as were pituitary abnormalities (29.0%).
• Cerebral microhemorrhages were less frequent (7.2%) but increased with TBI severity.

Conclusions:

• Blast-related TBI in military personnel frequently involves loss of consciousness.
• Structural MR imaging reveals a high incidence of chronic white matter abnormalities and pituitary changes.
• Microhemorrhages are infrequent in the chronic phase of mild TBI from blast.