Mild TBI Often Accompanied By Vascular Injury, Study Says

A new study has found that what is often diagnosed in brain trauma patients as diffuse axonal injury may in fact be bleeding, according to Clinical Psychiatry News.

http://www.clinicalpsychiatrynews.com/news/neurology/single-article/vascular-injury-common-in-mild-tbi/560180a7b00e7e6676ea50fa4ba761fb.html

The findings of the study, conducted by the National Institute of Neurological Disorders and Stroke, were presented last week at the annual meeting of the American Academy of Neurology. Neuroimaging fellow Dr. Gunjan Parikh told Clinical Psychiatry News “not everything we’re calling diffuse axonal injury is diffuse axonal injury. There may be, in fact, evidence under our noses of vascular injury.”

And as the doctor pointed out, if there is vascular injuries then there may be treatments to address them, which is not the case with diffuse axonal injury.

Diffuse axonal injury takes place in roughly half of all severe head traumas, and is caused when the brain bounces back and forth within the skull because of the acceleration or deceleration caused by car accidents, sports-related accidents, violence and  falls.

When the brain moves within the skull the axons, the parts of the nerve cells that allow neurons to send messages between them, are sheared and injured, creating lesions that cause unconsciousness or can put someone in a vegetiative state.

The study evaluated 256 patients from October 2010 to October 2012 who were enrolled in the Traumatic Head Injury Neuroimaging Classification (THINC) who had been admitted to hospital ERs in Bethesda and Washington. Researchers performed MRIs on the patients within 48 hour of their brain injury, as well as during as many as three follow-up visits, according to Clinical Psychiatry News.

Of the 256 patients, 104, or 41 percent, showed evidence of hemorrhage of the brain (with 67 percent reporting a loss of consciousness and 65 percent reporting amnesia).

Clinical Psychiatry News reported that the 104 patients then had brain scans with an advanced MRI within 17 hours of their injury. Those advanced tests showed that 20 percent of the 104 had microbleed lesions  and 33 percent had “tube-shaped linear lesions suggestive of vascular injury,” according to Clinical Psychiatry News.

So in a nutshell, one third of the patients had vascular injury, and they are the kind of brain injury patients who would then be sent home with no one trying to treat their vascular woes.