Aims and objectives
Aim of this study was to explore the dynamics of microstructure and brain metabolism parameters in children with severe traumatic brain injury ( sTBI ) and hypoxic-ischemic brain injury ( HIBI ). In this study,
we focused on three brain structures:corpus callosum (as an essential white matter structure),
thalamus (as an essentialgray matter structure) and brain stem. Corpus callosum (CC) is one of the most important structures that provides connections betweenbrain hemispheres.CC plays an...
Methods and materials
8 patients (mean age = 12.5) with sTBI comprised group 1.
4 children (mean age = 13.6) with HIBI caused by drowning in fresh water.
MR studies of patients from both groups were carried out twice: first - during the first seven days after injury (period 1); second - a month after injury (period 2).
All studies were performed at Phillips Achieva 3.0T MRI scanner. T1W 3D (TR = 8.1 ms,
TE = 3.7 ms,
FOV = 240 mm,
Thk 1 mm,
NSA = 1,
AQ = 5:37 min); DTI (TR = 9431 ms; TE = 70 ms,
1 H MRS analysis in thalamus revealed significant decrease in dynamics of NAA/Cho value in group 1 (41% decrease) and absence in dynamics of this index in group 2 (fig.1). No significant changes in dynamics of ADC and FA values were found in thalamus in two groups.
Significant increases in dynamics of ADC and FA values were found in corpus callosum in group 1 (fig.2). In group 2 we detected increase in dynamics of ADC value and NAA/Cho ratio in brain stem.
The significant decrease of NAA/Cho dynamics in thalamus in group 1 may indicate an active NAA intake in synthesis of oligodendrocytes to restore myelin sheath (fig.3). Correlation between changes in DTI parameters of corpus callosum in patients with TBI and severity ofhemisphericcerebral edemawas found. Dynamics of spectroscopy and DTI parameters in brain stem correlates with the restoration of CNS functions in patients after drowning.
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