From microbleeds to axonal damage: current evidence and future directions.

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Traumatic brain injury (TBI) is a global health issue.
• Traumatic axonal injury (TAI) significantly impacts TBI outcomes but is hard to measure directly in vivo.
• Cerebral microbleeds (CMBs) detected by susceptibility-based MRI are emerging as potential markers for TAI.

Purpose of the Study:

• To synthesize the literature on cerebral microbleeds (CMBs) in traumatic brain injury (TBI).
• To focus on susceptibility-based MRI and diffusion imaging for CMB detection and characterization.
• To discuss the utility of CMBs as context-dependent imaging markers in TBI.

Main Methods:

• Narrative synthesis of existing studies.
• Emphasis on susceptibility-based MRI sequences (GRE, SWI, QSM).
• Inclusion of diffusion tensor imaging (DTI) and neuropsychological correlates.

Main Results:

• CMBs are increasingly recognized as potential imaging markers in TBI.
• Susceptibility-based MRI techniques are crucial for CMB detection.
• Literature shows both convergence and inconsistency regarding CMBs and TAI.

Conclusions:

• CMBs hold promise as imaging markers for traumatic axonal injury (TAI) in TBI.
• Further research is needed to clarify methodological and conceptual aspects of CMB interpretation.
• Standardized approaches may enhance the clinical utility of CMBs in TBI assessment.