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Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury
10:33

Advanced Diffusion Imaging in The Hippocampus of Rats with Mild Traumatic Brain Injury

Published on: August 14, 2019

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Factors influencing the development of infantile traumatic brain injury with a biphasic clinical course and late

Madoka Yasukohchi1, Taku Omata1, Kenta Ochiai1

  • 1Department of Pediatrics, Tokyo Women's Medical University Yachiyo Medical Center, 477-96 Owadashinden, Yachiyo-shi, Chiba 276-8524, Japan.

Journal of the Neurological Sciences
|January 30, 2024
PubMed

Insights

Severe infantile traumatic brain injury (TBI) may lead to a biphasic course with late reduced diffusion (TBIRD). Prolonged seizures, intubation, and CT brain lesions indicate TBIRD risk, with the Tada score aiding prediction.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Trauma Surgery

Background:

  • Infantile traumatic brain injury (TBI) can present with a biphasic clinical course and late reduced diffusion, termed TBIRD.
  • Identifying pediatric TBI patients who develop TBIRD remains challenging.

Purpose of the Study:

  • To identify clinical and neuroimaging factors associated with the development of TBIRD in pediatric patients.
  • To evaluate the utility of the Tada score in predicting TBIRD.

Main Methods:

  • Retrospective study of pediatric TBI patients who underwent MRI.
  • Diagnosis of TBIRD based on clinical presentation (convulsions/consciousness disturbance) and late-onset subcortical reduced diffusion ('bright tree appearance').
  • Comparison of clinical features, neuroimaging (CT/MRI), laboratory data, and Tada score between TBIRD and non-TBIRD groups. Neurological prognosis assessed via Pediatric Cerebral Performance Category scale.

Main Results:

  • Seven out of 21 patients were diagnosed with TBIRD (median age 8 months).
  • Factors associated with TBIRD included seizures >30 min (5/7), tracheal intubation (5/7), and CT brain parenchymal lesions (3/7).
  • The Tada score was significantly more positive in TBIRD patients (6/7) compared to non-TBIRD patients (0/14).

Conclusions:

  • Infants with severe TBI require close monitoring for TBIRD development.
  • The Tada score shows promise as a predictive tool for identifying patients at risk of TBIRD.
Abstract

Keywords:
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD)Bright tree appearanceInfantile traumatic brain injury with a biphasic clinical course and late reduced diffusionSubdural hematomaTada scoreTraumatic brain injury

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