Researchers at Albert Einstein College of Medicine and Montefiore Health System were able to predict which patients, who recently suffered concussions, would most likely make a full recovery, thanks to a new advanced imaging system. The brains mechanisms for repairing or compensating for injuries were also highlighted in the study published in the American Journal of Neuroradiology. The study provided information that could lead to faster development of therapies.
2.5 million people in the U.S. suffer from traumatic brain injuries (TBI) each year, according to the Centers for Disease Control and Prevention. Of these injuries 75% are concussions. There is no objective biomarker or test for diagnosing concussions, only symptom assessment. These symptoms can last for seconds or not appear for days or weeks after trauma occurs. These symptoms may include seizures, sleep difficulty, diminished coordination, nausea and vomiting, slurred speech, confusion and memory loss.
Sarah Strauss M.D., the study’s author and resident in the department of radiology at Montefiore, said, “While most people think of concussions as a mild and short lived injury, 15 to 30 percent of patients are left with symptoms that persist indefinitely. Until now, we haven’t had a reliable way to differentiate in advance those who may be burdened long-term and those who would have a complete recovery.”
Imaging methods employed today, such as CT scans and MRI, do not have the capability of detecting subtle axonal damage that is consistent with many concussions. In a previous study, it was demonstrated that an advanced form of MRI called diffusion tensor imaging (DTI) can detect concussion related damage to axons, by study leader Michael L. Lipton, M.D., Ph.D. professor of radiology, of psychiatry and behavioral sciences, and of neuroscience and his colleagues. Dr. Lipton is also the associate director of the Gruss Magnetic Resonance Research Center (MRRC) at Einstein and director of MRI services at Montefiore.
Water molecules can be seen moving along axons in the DTI, allowing researchers to measure the uniformity of water movement throughout the brain. This axonal water movement is known as fractional anisotropy, or FA. Structural damage is located by regions of the brain with a low FA.
The Current Study
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Dr. Lipton, in the current study, performed DTI on 39 patients diagnosed with mild TBI by an emergency room physician within days of the initial injury and on 40 healthy controls. The goal was to determine whether brain abnormalities identified on DTI of individual concussion patients could distinguish who would recover fully and who would have indefinitely lasting symptoms. The DTI image of each patient was compared for the entire group of healthy controls to see where the injured brains were abnormal. Three measures were used for assessment. Those were cognitive function, post-concussion symptoms and health related quality of life measures. One year later follow up assessments were performed on 26 of the concussion patients.
Two types of white matter abnormalities were revealed in a comparison between the patients and the heathy controls; areas of abnormally low FA that correlate with axon damage and cognitive impairment and other areas with abnormally high FA that may be indicative of a favorable response to injury by the brain. This could be from efficiently connecting axons or by forming fatty tissues around nerves, allowing the nerve impulses to move more quickly. The patient’s outcomes were predicted by the amount of high FA in brains following a concussion. A higher abnormal amount of FA white matter areas was associated with more positive assessments of outcomes in follow-up testing.
Dr. Lipton opined that there is a need for further studies to validate this method of predicting concussion outcomes. Dr. Lipton said, “While we were able to predict the outcomes for the patients in our study; more refined approaches – incorporating additional patient and injury characteristics, for example – may be needed when applying the test on widely differing individuals.”
The Possible Impact on TBI Lawsuits
An individual who receives a traumatic brain injury may recover quickly with little or no detrimental effects. However, they may suffer a lifetime of debilitating symptoms. In a personal injury lawsuit, the cost to an individual in lost income, pain and suffering and long term medical costs, all effect the amount of compensation that may be awarded in a particular case. To be able to accurately assess a concussion patient’s probability and time for recovery could impact future cases significantly. The same test used to prove long term symptoms from damage by the plaintiff may be used to downplay the long term effects by the defendant.
Anyone who believes that they received a traumatic head injury due to negligence, or has a loved one who has, should seek the help of an experienced brain injury attorney. Proving the extent of the injury and duration of symptoms is paramount to the outcome. Only a qualified attorney should handle these delicate cases.
Dolman Law has successfully represented countless victims of traumatic brain injury due to negligence, recovering substantial compensatory damages. If you or someone you care about were injured, speak with a qualified brain injury attorney today. Call 727-222-6922. There is no cost for a confidential evolution of your case.
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