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The association between microhaemorrhages and post - traumatic functional outcome in the chronic phase after mild traumatic brain injury

  • Diagnostic Neuroradiology
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Abstract

Purpose

In the chronic phase after mild traumatic brain injury (mTBI), microhaemorrhages are frequently detected on magnetic resonance imaging (MRI). It is however unclear whether microhaemorrhages are associated with functional outcome and which MRI sequence is most appropriate to address this association. We aimed to determine the association between microhaemorrhages and functional outcome in the chronic posttraumatic phase after injury with the most suitable MRI sequence to address this association.

Methods

One hundred twenty-seven patients classified with mTBI admitted to the outpatient clinic from 2008 to 2015 for persisting posttraumatic complaints were stratified according to the presence of MRI abnormalities (n = 63 (MRI+ group) and n = 64 without abnormalities (MRI− group)). For the detection of microhaemorrhages, susceptibility-weighted imaging (SWI) and T2* gradient recalled echo (T2*GRE) were used. The relation between the functional outcome (dichotomized Glasgow Outcome Scale Extended scores) and the number and localization of microhaemorrhages was analysed using binary logistic regression.

Results

SWI detected twice as many microhaemorrhages compared to T2*GRE: 341 vs. 179. Lesions were predominantly present in the frontal and temporal lobes. Unfavourable outcome was present in 67% of the MRI+ group with a significant association of total number of microhaemorrhages in the temporal cortical area on SWI (OR 0.43 (0.21–0.90) p = 0.02), with an explained variance of 44%. The number of microhaemorrhages was not correlated with the number of posttraumatic complaints.

Conclusion

An unfavourable outcome in the chronic posttraumatic phase is associated with the presence and number of microhaemorrhages in the temporal cortical area. SWI is preferably used to detect these microhaemorrhages.

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Authors and Affiliations

  1. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    S. de Haan & J. C. de Groot

  2. Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    B. Jacobs & J. van der Naalt

Authors
  1. S. de Haan
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  2. J. C. de Groot
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  3. B. Jacobs
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  4. J. van der Naalt
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Corresponding author

Correspondence to J. van der Naalt.

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This study was not funded.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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de Haan, S., de Groot, J.C., Jacobs, B. et al. The association between microhaemorrhages and post - traumatic functional outcome in the chronic phase after mild traumatic brain injury. Neuroradiology 59, 963–969 (2017). https://doi.org/10.1007/s00234-017-1898-8

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  • DOI: https://doi.org/10.1007/s00234-017-1898-8

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