Faculty Collaboration Database

Proton magnetic resonance spectroscopy for detection of axonal injury in the splenium of the corpus callosum of brain-injured patients. J Neurosurg 1998 May;88(5):795-801

Date

05/12/1998

Pubmed ID

9576245

DOI

10.3171/jns.1998.88.5.0795

Scopus ID

2-s2.0-0031900582 (requires institutional sign-in at Scopus site)   204 Citations

Abstract

OBJECT: This study was conducted to determine whether proton magnetic resonance spectroscopy (MRS) is a sensitive method for detecting diffuse axonal injury, which is a primary sequela of traumatic brain injury (TBI). Diffuse axonal injury is characterized by selective damage to white matter tracts that is caused in part by the severe inertial strain created by rotational acceleration and deceleration, which is often associated with motor vehicle accidents. This axonal injury is typically difficult to detect by using conventional imaging techniques because it is microscopic in nature. The splenium was selected because it is a site vulnerable to shearing forces that produce diffuse axonal injury.

METHODS: The authors used proton MRS to evaluate the splenium, the posterior commissure of the corpus callosum, in normal control volunteers and in patients with TBI. Proton MRS provided an index of neuronal and axonal viability by measuring levels of N-acetyl aspartate (NAA).

CONCLUSIONS: A majority of mildly brain injured patients, as well as those more severely injured, showed diminished NAA/creatine (Cr) levels in the splenium compared with normal control volunteers. The patients displaying lowered NAA/Cr in the splenium were also likely to exhibit lowered NAA/Cr in lobar white matter. Also, the levels of NAA/Cr in the splenium of normal volunteers were higher compared with those found in lobar white matter. Decreases in NAA/Cr levels in the splenium may be a marker for diffuse injury. A proton MRS examination may be particularly useful in evaluating mildly injured patients with unexplained neurological and cognitive deficits. It is concluded that MRS is a sensitive tool in detecting axonal injury.

Author List

Cecil KM, Hills EC, Sandel ME, Smith DH, McIntosh TK, Mannon LJ, Sinson GP, Bagley LJ, Grossman RI, Lenkinski RE

Author

Grant P. Sinson MD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acceleration
Accidents, Traffic
Adult
Aged
Aspartic Acid
Axons
Brain Concussion
Brain Diseases
Brain Injuries
Cell Survival
Cerebral Hemorrhage
Cognition Disorders
Corpus Callosum
Creatine
Deceleration
Female
Hematoma, Epidural, Cranial
Hematoma, Subdural
Humans
Magnetic Resonance Imaging
Magnetic Resonance Spectroscopy
Male
Middle Aged
Neurons
Protons
Rotation
Stress, Mechanical