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University of Maryland School of Medicine Researcher Finds Evidence That Even Minor Head Injuries May Have Lasting Impact

Tuesday, March 12, 2013

 Using MRI, Dr. Parikh was able to document differences in injuries that are often classified as the same.

The University of Maryland School of Medicine’s Gunjan Parikh, MD, and collaborators have found that brain imaging done soon after mild traumatic brain injury (mTBI) can detect tiny lesions that may eventually provide a target for treating people with mTBI, according to a study released today. Dr. Parikh, a Visiting Professor in the Department of Neurology, will present the findings at the American Academy of Neurology’s 65th Annual Meeting in San Diego, March 16-23, 2013.

Studies of brain tissue once a person has died have shown that different types of lesions are associated with exposure to repetitive mild TBI. "Our study suggests that imaging may be used to detect and distinguish between these lesions in a living person, and this finding has important implications for treatment," said Dr. Parikh, who conducted the study at the National Institutes of Neurological Disorders and Stroke. Dr. Parikh is also an attending neurointensivist at the University of Maryland R Adams Cowley Shock Trauma Center and a member of the American Academy of Neurology.
The study involved 256 people with an average age of 50 who were admitted to the emergency department after mild head injuries. Of those, 104 had imaging evidence of hemorrhage in the brain (67 percent reported loss of consciousness, and 65 percent reported amnesia or temporary forgetfulness). Patients with hemorrhages underwent more detailed brain scans with advanced magnetic resonance imaging within an average of 17 hours after the injury.

Advanced imaging showed that — of those 104 with evidence of hemorrhage — 20 percent had microbleed lesions and 33 percent had tube-shaped linear lesions. Microbleeds were distributed throughout the brain, whereas linear lesions were found mainly in one area, were more likely to be graded as severe, and were more likely to have injury to adjacent brain tissue.

The investigators hypothesized that the linear lesions seen on MRI may represent a type of vascular injury that is often seen in brain tissue studies of people with more severe TBI. "If that theory is confirmed, it may provide an opportunity to develop treatment strategies for people who have suffered a mild TBI," said Dr. Parikh.

These findings are important because evidence increasingly shows that athletes and military service personnel who suffer repetitive mild traumatic brain injuries can sometimes later develop a serious neurodegenerative disorder known as chronic traumatic encephalopathy, which has been associated with behavioral and mood changes, as well as cognitive impairment.

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