Clinical and MRI predictors of coma duration, intensive care and outcome of traumatic brain injury

Потапов, А. А.; Danilov, Gleb; Сычев, А А; Захарова, Н. Е.; Pronin, Igor; Савин, И А; Ошоров, А В; Полупан, А. А.; Aleksandrova, E V; Strunina, Yu V; Likhterman, L. B.; Охлопков, В. А.; Latyshev, Ya A; Chelushkin, D M; Баранич, А И; Кравчук, А Д

doi:10.17116/neiro2020840415

Cited by 12 publications

(3 citation statements)

References 27 publications

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“…The findings from various morphological studies, structural MRI, and tractography align with the idea that traumatic unconscious states are primarily caused by multi-level structural and functional disconnections including those caused by axonal rupture during and after diffuse axonal damage (Hayes et al 2016;Potapov et al 2020;Zakharova et al 2014). The extent of post-traumatic consciousness alteration was shown to be linked to the integrity of the corpus callosum (CC) (Zakharova et al 2014;Zhang et al 2017) as well as of longitudinal intrahemispheric tracts such as the superior and inferior longitudinal fasciculi (SLF and ILF) (Hayes et al 2016) and the inferior fronto-occipital fasciculus (IFOF) (Tan et al 2022).…”

Section: Introductionsupporting

confidence: 58%

“…Severe traumatic brain injury (sTBI) is often accompanied by alterations of consciousness manifesting as prolonged postcomatose unawareness states (disorders of consciousness, DOC) (Giacino et al 2014;Giacino et al 2018;Kondrat'eva and Yakovenko 2014;Laureys et al 2009;Piradov et al 2018;Potapov et al 2020;Potapov et al 2009). DOC affect stages that follow coma and succeed each other, beginning with the first postcomatose eye-opening and culminating in the establishment of contact with a patient and the ability to follow commands (Dobrokhotova et al 1996;Laureys et al 2009;Zaytsev 2014).…”

Section: Introductionmentioning

confidence: 99%

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Significance of the Corpus Callosum and Inferior Fronto-Occipital Fasciculus in Recovery after Traumatic Brain Injury

Pogosbekian,

Sharova,

Fadeeva

et al. 2024

Preprint

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Objective: To analyze the correlations between the consciousness state scores and the fractional anisotropy (FA) values in various segments of the Corpus Callosum (CC) and Inferior Fronto-Occipital Fasciculus (IFOF) at different stages of recovery after traumatic brain injury (TBI). Methods: Diffusion tensor imaging (DTI) was performed in 43 TBI patients and 22 healthy volunteers. The consciousness levels were estimated with the CRS-R scale. The tracts were divided into segments using a template based on tractograms of healthy volunteers, and the correlations between the CRS-R scores and the FA values were calculated for each tract segment. Results: In the acute period after TBI, 15 segments of the CC and IFOF demonstrated significant correlations (p<0.05). In the long-term period, the highest number (24) of correlations were found in the studied tracts segments. In the subacute period, only 3 segments with correlations were detected. Conclusions: We propose a new pipeline, which yields spatial localization of correlations between the fractional anisotropy values and the CRS-R scores in patients after TBI. It allows to make assumptions about the functioning of neural networks. Significance: This work provides new information concerning the organization of fiber tracts and neural networks in TBI patients and may improve neurorehabilitation approaches.

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Section: Introductionsupporting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Significance of the Corpus Callosum and Inferior Fronto-Occipital Fasciculus in Recovery after Traumatic Brain Injury

Pogosbekian,

Sharova,

Fadeeva

et al. 2024

Preprint

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show abstract

“…[13] While most prognostic studies focused on post-discharge outcomes, several studies showed that diffuse axonal injury and brainstem lesions on inpatient MRI were associated with increased duration and intensity of inpatient care as well as poor functional status at discharge. [20][21][22][23] In contrast, the mechanisms by which diagnostic information obtained from MRI may alter patient management and improve the mortality rate in TBI patients remain unclear. Previously, Fiser et al evaluated 40 hospitalized acute TBI patients to find that addition of MRI did not led lead to change in patient management despite detection of more injuries.…”

Section: Discussionmentioning

confidence: 99%

Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality

Lee

Yang

et al. 2021

JCIS

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Objectives: While magnetic resonance imaging (MRI) has higher sensitivity than computed tomography for certain types of traumatic brain injury (TBI), it remains unknown whether the increased detection of intracranial injuries leads to improved clinical outcomes in acute TBI patients, especially given the resource requirements involved in performing MRI. We leveraged a large national patient database to examine associations between brain MRI utilization and inpatient clinical outcomes in hospitalized TBI patients. Material and Methods: The National Inpatient Sample database was queried to find 3,075 and 340,090 hospitalized TBI patients with and without brain MRI, respectively, between 2012 and 2014 in the United States. Multivariate regression analysis was performed to independently evaluate the association between brain MRI utilization and inpatient mortality rate, complications, and resource requirements. Results: The MRI group had a lower unadjusted mortality rate of 0.75% compared to 2.54% in the non-MRI group. On multivariate regression analysis, inpatient brain MRI was independently associated with lower mortality (adjusted OR 0.32, 95% CI 0.12–0.86), as well as higher rates of intracranial hemorrhage (adjusted OR 2.20, 95% CI 1.27–3.81) and non-home discharge (adjusted OR 1.33, 95% CI 1.07–1.67). Brain MRI was independently associated with 3.4 days (P < 0.001) and $8,934 (P < 0.001) increase in the total length and cost of hospital stay, respectively. Conclusion: We present the first evidence that inpatient brain MRI in TBI patients is associated with lower inpatient mortality, but with increased hospital resource utilization and likelihood of non-home discharge.

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Chronic Disorders of Consciousness: Diagnosis and Prognosis

Mayorova

Petrova

Pryanikov

et al. 2021

Neurosci Behav Physi

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Clinical and MRI predictors of coma duration, intensive care and outcome of traumatic brain injury

Cited by 12 publications

References 27 publications

Significance of the Corpus Callosum and Inferior Fronto-Occipital Fasciculus in Recovery after Traumatic Brain Injury

Significance of the Corpus Callosum and Inferior Fronto-Occipital Fasciculus in Recovery after Traumatic Brain Injury

Use of Magnetic Resonance Imaging in Acute Traumatic Brain Injury Patients is Associated with Lower Inpatient Mortality

Chronic Disorders of Consciousness: Diagnosis and Prognosis

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