In a first-of-its-kind study, a team of researchers from the University of California San Francisco tracked patients with mild traumatic brain injury (mTBI) for up to a year after diagnosis by CT in Level 1 trauma centers in the US. “In this study, while reconfirming the importance of patient baseline characteristics in mTBI outcome, we demonstrate for the first time (to our knowledge) that different pathological subtypes of intracranial hemorrhage are not equivalent in their implications for prognosis,” wrote Lead Author Esther Yuh and her colleagues.

The team’s cohort study found “…subarachnoid hemorrhage, subdural hematoma, and contusion often co-occurred and were associated with both incomplete recovery and more severe impairment out to 12 months after injury, while intraventricular and/or petechial hemorrhage co-occurred and were associated with more severe impairment up to 12 months after injury; epidural hematoma was associated with incomplete recovery at some points but not with more severe impairment. Some intracranial hemorrhage patterns were more strongly associated with outcomes than previously validated demographic and clinical variables.”

The authors concluded “Based on 2 large observational studies conducted on different continents, contusion, SAH, SDH, IVH, and petechial hemorrhage are associated with adverse outcomes across a broad range of GOSE scores up to 1 year after mTBI, while EDH is not. These routinely obtained imaging findings can be used to identify patients at risk for unfavorable outcomes and improve clinical trial design. Patients with mTBI and these CT features should be considered for TBI-specific education and systematic follow-up.”

Source:

Yuh EL, Jain S, Sun X, et al. Pathological Computed Tomography Features Associated With Adverse Outcomes After Mild Traumatic Brain Injury: A TRACK-TBI Study With External Validation in CENTER-TBI. JAMA Neurol. Published online July 19, 2021. doi:10.1001/jamaneurol.2021.2120 Available: https://jamanetwork.com/journals/jamaneurology/fullarticle/2781920?resultClick=1 Accessed: August 9, 2021.

Article published as Open Access under the terms of the CC-BY License.