Abnormal asymmetry correlates with abnormal enlargement in a patient with chronic moderate traumatic brain injury

Abstract

Aim: Recent studies found patients with chronic, mild or moderate traumatic brain injury had more regions of enlargement than atrophy. There is little research discussing brain volume enlargement, asymmetry and TBI. Materials & methods: In this report, we describe a 40-year-old man who suffered a left cerebral hemorrhage resulting in a moderate TBI, suggesting greater forces on the left side of his brain. NeuroQuant® brain volumetric analyses of his MRI obtained 1.7 years post injury showed left cerebral white matter atrophy but right gray matter abnormal enlargement. Abnormal asymmetry of multiple regions (R >L) was confirmed by NeuroGage® asymmetry analyses. Discussion: The findings suggested that abnormal brain volume enlargement was due to hyperactivity and hypertrophy of less-injured brain regions as a compensatory response to more-injured regions.

Journey to the other side of the brain: asymmetry in patients with chronic mild or moderate traumatic brain injury

“…Regarding calculation of asymmetry, our methods have been described in detail previously [ 6 ]. In brief, asymmetry values were calculated using the same formula used by NeuroQuant ® , that is: Asymmetry index = (Left_volume – Right_volume)/(Mean of Left_Volume and Right_Volume), expressed as a percentage.…”

“…The hypotheses of neuroinflammation versus compensatory hypertrophy were explored in a recent report describing the case of a 42-year-old man who sustained a moderate traumatic brain injury characterized by day-of-injury left cerebral hemorrhage, followed 1.8 years later by CWM atrophy ipsilateral to the side of injury (i.e. left-sided) but contralateral (i.e., right) abnormal enlargement of the thalamus and multiple cerebral cortical gray matter regions [ 6 ]. (Herein, we will use the term ‘non-CWM regions’ to refer to regions other than CWM, which have been found to be abnormally large in patients with chronic mild or moderate TBI, including cerebral cortical gray matter and subcortical regions; see below for further information.)…”