Related Experiment Video
Updated: Aug 9, 2025
Development of an Uncomplicated Mild Traumatic Brain Injury Model Modified by Weight-Drop Method and Evidenced by Magnetic Resonance Imaging
Published on: April 11, 2025
White matter hyperintensities and cerebral microbleeds in persistent post-traumatic headache attributed to mild
Håkan Ashina1,2,3, Rune H Christensen2, Haidar Muhsen Al-Khazali2
1Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Objective:
To examine whether white matter hyperintensities (WMHs) and cerebral microbleeds (CMBs) are more prevalent in people with persistent post-traumatic headache attributed to mild traumatic brain injury (TBI), compared with healthy controls.
Methods:
A magnetic resonance imaging (MRI) study of adults with persistent post-traumatic headache attributed to mild TBI and age- and gender-matched healthy controls. A semi-structured interview and validated self-report instruments were used to record data on demographics, clinical characteristics, and comorbidities. Imaging data were obtained on a 3T MRI Scanner using a 32-channel head coil. Participants and controls underwent a single MRI session, in which fluid-attenuated inversion recovery was used to visualize WMHs, and susceptibility-weighted imaging was used to detect CMBs. The primary outcomes were (I) the difference in the mean number of WMHs between participants with persistent post-traumatic headache and healthy controls and (II) the difference in the mean number of CMBs between participants with persistent post-traumatic headache and healthy controls. All images were examined by a certified neuroradiologist who was blinded to the group status of the participants and controls.
Results:
A total of 97 participants with persistent post-traumatic headache and 96 age- and gender-matched healthy controls provided imaging data eligible for analyses. Among 97 participants with persistent post-traumatic headache, 43 (44.3%) participants presented with ≥ 1 WMH, and 3 (3.1%) participants presented with ≥ 1 CMB. Compared with controls, no differences were found in the mean number of WMHs (2.7 vs. 2.1, P = 0.58) and the mean number of CMBs (0.03 vs. 0.04, P = 0.98).
Conclusions:
WMHs and CMBs were not more prevalent in people with persistent post-traumatic headache than observed in healthy controls. Future studies should focus on other MRI techniques to identify radiologic biomarkers of post-traumatic headache.
Insights
White matter hyperintensities (WMHs) and cerebral microbleeds (CMBs) were not more common in individuals with persistent post-traumatic headache after mild traumatic brain injury (TBI). Further research using advanced MRI techniques is needed to find biomarkers for this condition.
Area of Science:
- Neurology
- Radiology
- Neuroscience
Background:
- Persistent post-traumatic headache (PTH) following mild traumatic brain injury (TBI) is a common and disabling condition.
- The underlying neuroimaging correlates of PTH are not well understood.
- White matter hyperintensities (WMHs) and cerebral microbleeds (CMBs) are potential markers of brain injury.
Purpose of the Study:
- To investigate the prevalence of WMHs and CMBs in adults with persistent PTH attributed to mild TBI.
- To compare the frequency of WMHs and CMBs in PTH patients versus healthy controls.
Main Methods:
- A case-control study involving adults with persistent PTH (n=97) and age/gender-matched healthy controls (n=96).
- Magnetic resonance imaging (MRI) using 3T scanner with 32-channel head coil.
- Fluid-attenuated inversion recovery (FLAIR) for WMHs and susceptibility-weighted imaging (SWI) for CMBs.
- Images were analyzed by a blinded, certified neuroradiologist.
Main Results:
- No significant difference in the mean number of WMHs between PTH patients (2.7) and controls (2.1, P=0.58).
- No significant difference in the mean number of CMBs between PTH patients (0.03) and controls (0.04, P=0.98).
- 44.3% of PTH patients had ≥1 WMH, and 3.1% had ≥1 CMB.
Conclusions:
- WMHs and CMBs are not more prevalent in individuals with persistent PTH after mild TBI compared to healthy individuals.
- Current MRI markers (WMHs, CMBs) do not appear to be associated with persistent PTH.
- Future research should explore advanced MRI techniques to identify potential radiologic biomarkers for PTH.
