INTRODUCTION: Loss of consciousness (LOC) is used as a diagnostic feature of mild traumatic brain injury (MTBI). However, only 10% of concussions result in LOC. There are only a limited number of in-vivo studies dealing with unconsciousness and structural and functional integrity of the brainstem in patients with MTBI. The aim of our pilot study was to assess the sensitivity of proton magnetic resonance spectroscopy (1H-MRS) to detect metabolic changes in the brainstem in patients after MTBI with unconscioussness. METHODS: Twenty-four patients (12 with LOC, and 12 without LOC) within 3 days of MTBI and 19 healthy controls were examined. All subjects underwent single-voxel 1H-MRS examination of the upper brainstem. Spectra were evaluated using LCModel software. Ratios of total N-acetylaspartate (tNAA), total choline-containing compounds (tCho) and glutamate plus glutamine (Glx) to total creatine (tCre) were used for calculations. RESULTS: We found a significant decrease in tNAA/tCre and tCho/tCre ratios in the patient group with LOC when compared with the control group of healthy volunteers (P=0.002 and P=0.041, respectively), and a significant decrease in the tNAA/tCre ratio in the LOC group when compared with patients without LOC (P=0.04). Other metabolite ratios in the brainstem did not show any significant group differences. CONCLUSION: Our findings indicate that decrease of tNAA/tCre ratio in the upper brainstem using single-voxel 1H-MRS may provide a potential biomarker for MTBI associated with LOC.
Ľahké mozgové poranenie (ĽMP) patrí medzi najčastejšie diagnózy, s ktorými sa stretáva neurológ vo svojej praxi. Napriek dôležitým poznatkom získaným za posledné desaťročia zostáva v rámci tejto klinickej jednotky stále mnoho otázok. Článok obsahuje prehľad terminológie ochorenia, zásady diagnostického postupu so zameraním na indikačné kritériá zobrazovacích vyšetrení u dospelých pacientov aj detí a princípy liečby v iniciálnom poúrazovom období.
Mild traumatic brain injury (MTBI) is among the most common diagnoses encountered by a neurologist in the clinical practice. Despite several important findings in recent decades, there are still many question marks. The article provides an overview of disease terminology, the principles of diagnosis with a focus on the indication criteria for imaging in adult patients and children and the principles of treatment in the initial post-traumatic period.
- MeSH
- komoce mozku terapie MeSH
- kraniocerebrální traumata terapie MeSH
- lidé MeSH
- management nemoci MeSH
- poranění mozku * terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
