Diffusion-weighted imaging of Wallerian degeneration in non-accidental head injury

Ajilogba, Kaseem; Rao, Padma

doi:10.1007/s00247-006-0286-z

Cited by 3 publications

(2 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was first described histopathologically by Waller in 1850 . In the brain, WD occurs after a variety of insults including ischemic stroke, multiple sclerosis, traumatic brain injury, and intracerebral hemorrhage (ICH) …”

Section: Introductionmentioning

confidence: 99%

Natural History and Prognostic Value of Corticospinal Tract Wallerian Degeneration in Intracerebral Hemorrhage

Venkatasubramanian

Kleinman

Fischbein

et al. 2013

JAHA

View full text Add to dashboard Cite

BackgroundThe purpose of this study was to define the incidence, imaging characteristics, natural history, and prognostic implication of corticospinal tract Wallerian degeneration (CST‐WD) in spontaneous intracerebral hemorrhage (ICH) using serial MR imaging.Methods and ResultsConsecutive ICH patients with supratentorial ICH prospectively underwent serial MRIs at 2, 7, 14, and 21 days. MRIs were analyzed by independent raters for the presence and topographical distribution of CST‐WD on diffusion‐weighted imaging (DWI). Baseline demographics, hematoma characteristics, ICH score, and admission National Institute of Health Stroke Score (NIHSS) were systematically recorded. Functional outcome at 3 months was assessed by the modified Rankin Scale (mRS) and the motor‐NIHSS. Twenty‐seven patients underwent 93 MRIs; 88 of these were serially obtained in the first month. In 13 patients (48%), all with deep ICH, CST‐WD changes were observed after a median of 7 days (interquartile range, 7 to 8) as reduced diffusion on DWI and progressed rostrocaudally along the CST. CST‐WD changes evolved into T2‐hyperintense areas after a median of 11 days (interquartile range, 6 to 14) and became atrophic on MRIs obtained after 3 months. In univariate analyses, the presence of CST‐WD was associated with poor functional outcome (ie, mRS 4 to 6; P=0.046) and worse motor‐NIHSS (5 versus 1, P=0.001) at 3 months.ConclusionsWallerian degeneration along the CST is common in spontaneous supratentorial ICH, particularly in deep ICH. It can be detected 1 week after ICH on DWI and progresses rostrocaudally along the CST over time. The presence of CST‐WD is associated with poor motor and functional recovery after ICH.

show abstract

Section: Introductionmentioning

confidence: 99%

Natural History and Prognostic Value of Corticospinal Tract Wallerian Degeneration in Intracerebral Hemorrhage

Venkatasubramanian

Kleinman

Fischbein

et al. 2013

JAHA

View full text Add to dashboard Cite

show abstract

“…Other case reports or series have also demonstrated DWI changes in white matter after NAT, suggesting that DWI is more sensitive than conventional MRI and more likely to detect lesions earlier in the evolution of an injury [Chan et al, 2003;Parizel et al, 2003;Ajilogba and Rao, 2006;Dan et al, 2008;McKinney et al, 2008]. These reports also noted large areas of dramatic diffusion restriction, which supports the belief that ischemia is a major component of brain injury in NAT, probably more so than DAI.…”

Section: Dwi In the Evaluation Of Natmentioning

confidence: 76%

Advanced Neuroimaging in Children with Nonaccidental Trauma

2010

View full text Add to dashboard Cite

Physical abuse associated with nonaccidental trauma (NAT) affects approximately 144,000 children per year in the USA and, frequently, these injuries affect the developing brain. Most infants with suspected NAT are initially evaluated by skull X-rays and computed tomography to determine whether fractures are present, the severity of the acute injury and the need for urgent neurosurgical intervention. Increasingly, magnetic resonance imaging (MRI) is conducted as it provides additional diagnostic and prognostic information about the extent and nature of the injury. In this review, we examine 4 MRI techniques as they apply to children who present acutely after NAT. Susceptibility-weighted imaging is a 3-D high-resolution MRI technique that is more sensitive than conventional imaging in detecting hemorrhagic lesions that are often associated with diffuse axonal injury (DAI). Magnetic resonance spectroscopy acquires metabolite information reflecting neuronal integrity and function from multiple brain regions and provides a sensitive, noninvasive assessment of neurochemical alterations that offers early prognostic information regarding outcome. Diffusion-weighted imaging (DWI) is based on differences in the diffusion of water molecules within the brain and has been shown to be very sensitive in the early detection of ischemic injury. It is now being used to study the direct effects of traumatic injury as well as those due to secondary ischemia. Diffusion tensor imaging is a form of DWI and allows better evaluation of white matter fiber tracts by taking advantage of the intrinsic directionality (anisotropy) of water diffusion in the human brain. It has been shown to be useful in identifying white matter abnormalities after DAI when conventional imaging appears normal. Although these imaging methods have been studied primarily in adults and children with accidental traumatic brain injury, it is clear that they have the potential to provide additional value in the imaging and clinical evaluation of children with NAT.

show abstract

Advanced Neuromonitoring and Imaging in Pediatric Traumatic Brain Injury

Friess

Kilbaugh

Huh

2012

Critical Care Research and Practice

View full text Add to dashboard Cite

While the cornerstone of monitoring following severe pediatric traumatic brain injury is serial neurologic examinations, vital signs, and intracranial pressure monitoring, additional techniques may provide useful insight into early detection of evolving brain injury. This paper provides an overview of recent advances in neuromonitoring, neuroimaging, and biomarker analysis of pediatric patients following traumatic brain injury.

show abstract

Diffusion-weighted imaging of Wallerian degeneration in non-accidental head injury

Cited by 3 publications

References 1 publication

Natural History and Prognostic Value of Corticospinal Tract Wallerian Degeneration in Intracerebral Hemorrhage

Natural History and Prognostic Value of Corticospinal Tract Wallerian Degeneration in Intracerebral Hemorrhage

Advanced Neuroimaging in Children with Nonaccidental Trauma

Advanced Neuromonitoring and Imaging in Pediatric Traumatic Brain Injury

Contact Info

Product

Resources

About