ArticleNeurocritical care2017
Revisiting Grade 3 Diffuse Axonal Injury: Not All Brainstem Microbleeds are Prognostically Equal.
Article in Neurocritical care, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
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Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Toward a global and reproducible science for brain imaging in neurotrauma: the ENIGMA adult moderate/severe traumatic brain injury working group.Brain imaging and behavior · 2021Pooled it
- Prognostic Value of MRI Anatomical Radiologic Scores for One-Year Neurological Outcome After Severe Traumatic Brain Injury.Neurocritical care · 2026Observational
- Traumatic Microhemorrhages Are Not Synonymous With Axonal Injury.Annals of clinical and translational neurology · 2026Article
- Relevance of cerebral microbleeds with leaky blood brain barrier in traumatic brain injury and protective role of interferon-gamma: A cohort study.Cerebral circulation - cognition and behavior · 2026Article
- Automated MRI Segmentation of Brainstem Nuclei Critical to Consciousness.Human brain mapping · 2025Observational
- Traumatic brain injury management in the intensive care unit: standard of care and knowledge gaps.Intensive care medicine · 2025Review
- LONG-TERM OUTCOMES OF MODERATE TO SEVERE DIFFUSE AXONAL TRAUMATIC BRAIN INJURY: A PROSPECTIVE STUDY.Journal of rehabilitation medicine. Clinical communications · 2025Article
- Recovery of consciousness after acute brain injury: a narrative review.Journal of intensive care · 2024Review
- Mastering the brain in critical conditions: an update.Intensive care medicine experimental · 2024Article
- Common Data Elements for Disorders of Consciousness: Recommendations from the Working Group on Neuroimaging.Neurocritical care · 2023Article
- Evaluating the state of non-invasive imaging biomarkers for traumatic brain injury.Neurosurgical review · 2023Review
- Prognosis of consciousness disorders in the intensive care unit.Presse medicale (Paris, France : 1983) · 2023Review
- Clinical Decision on Disorders of Consciousness After Acquired Brain Injury: Stepping Forward.Neuroscience bulletin · 2023Review
- Serum biomarkers identify critically ill traumatic brain injury patients for MRI.Critical care (London, England) · 2022Article
- The radiological interpretation of possible microbleeds after moderate or severe traumatic brain injury: a longitudinal study.Neuroradiology · 2022Article
- Return to Work Within Four Months of Grade 3 Diffuse Axonal Injury.The Neurohospitalist · 2022Article
- Extended Analysis of Axonal Injuries Detected Using Magnetic Resonance Imaging in Critically Ill Traumatic Brain Injury Patients.Journal of neurotrauma · 2022Article
- Location of Subcortical Microbleeds and Recovery of Consciousness After Severe Traumatic Brain Injury.Neurology · 2021Article
- Recovery from disorders of consciousness: mechanisms, prognosis and emerging therapies.Nature reviews. Neurology · 2021Review
- Traumatic brain injury-induced cerebral microbleeds in the elderly.GeroScience · 2021Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundRecovery of functional independence is possible in patients with brainstem traumatic axonal injury (TAI), also referred to as "grade 3 diffuse axonal injury," but acute prognostic biomarkers are lacking. We hypothesized that the extent of dorsal brainstem TAI measured by burden of traumatic microbleeds (TMBs) correlates with 1-year functional outcome more strongly than does ventral brainstem, corpus callosal, or global brain TMB burden. Further, we hypothesized that TMBs within brainstem nuclei of the ascending arousal network (AAN) correlate with 1-year outcome.
methodsUsing a prospective outcome database of patients treated for moderate-to-severe traumatic brain injury at an inpatient rehabilitation hospital, we retrospectively identified 39 patients who underwent acute gradient-recalled echo (GRE) magnetic resonance imaging (MRI). TMBs were counted on the acute GRE scans globally and in the dorsal brainstem, ventral brainstem, and corpus callosum. TMBs were also mapped onto an atlas of AAN nuclei. The primary outcome was the disability rating scale (DRS) score at 1 year post-injury. Associations between regional TMBs, AAN TMB volume, and 1-year DRS score were assessed by calculating Spearman rank correlation coefficients.
resultsMean ± SD number of TMBs was: dorsal brainstem = 0.7 ± 1.4, ventral brainstem = 0.2 ± 0.6, corpus callosum = 1.8 ± 2.8, and global = 14.4 ± 12.5. The mean ± SD TMB volume within AAN nuclei was 6.1 ± 18.7 mm
conclusionsThese findings suggest that dorsal brainstem TAI, especially involving AAN nuclei, may have greater prognostic utility than the total number of lesions in the brain or brainstem.
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