Thursday, July 22, 2021

Imaging After Mild Brain Injury May Predict Outcomes

And why would you want to know about failure to recover? Instead of delivering recovery protocols? This is worthless. 

Imaging After Mild Brain Injury May Predict Outcomes

Certain features that appear on CT scans help predict outcomes following mild traumatic brain injury (TBI), according to a study published in JAMA Neurology.

Patterns detected on the scans may help guide follow-up treatment, as well as improve recruitment and research study design for head injury clinical trials, according to Geoffrey Manley, MD, University of California San Francisco, San Francisco, California.

The Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study included 1,935 patients with mild TBI. All patients underwent CT scans and were followed for up to 12 months after their injury.

The researchers identified 3 distinct sets of patterns on the CT scans, indicating different types of damage after head injury which were associated with various outcomes. The results suggest that contusion, subarachnoid haemorrhage , subdural haematoma, and intraventricular haemorrhage were associated with worse outcomes 12 months after injury.

Epidural haematoma was associated with incomplete recovery at 2 weeks and 3 months, but was not linked to negative longer-term outcomes.

“In this cohort study, subarachnoid haemorrhage, subdural haematoma, and contusion often co-occurred and were associated with both incomplete recovery and more severe impairment out to 12 months after injury, while intraventricular and/or petechial haemorrhage co-occurred and were associated with more severe impairment up to 12 months after injury,” the authors wrote. “Epidural haematoma was associated with incomplete recovery at some points but not with more severe impairment. Some intracranial haemorrhage patterns were more strongly associated with outcomes than previously validated demographic and clinical variables.”

The authors noted that, to their knowledge, this is the first time the existence of common CT patterns or phenotypes of intracranial injury in mid TBI has been demonstrated, and show that these different phenotypes have varying implications for outcomes up to 1 year postinjury.

Reference: https://jamanetwork.com/journals/jamaneurology/fullarticle/2781920

SOURCE: National Institutes of Health

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