TBI may be the result of a variety of accidents and occurrences. First, TBI can result from direct blows to the head, gunshot wounds, violent shaking of the head, or by force from a whiplash sort of injury. Secondly, TBI is seen in cases of concussions, produced when the brain experiences trauma from an impact, sudden momentum or movement change, and, as a result, the blood vessels in the brain stretch and the cranial nerves can become damaged.
Some concussions can cause a blood clot in the brain to form, becoming fatal. Concussions can take a few months to a few years to fully heal. Moreover, TBI can be a contusion resulting from a direct impact to the head, causing bleeding within the brain. TBI can also be a diffuse axonal injury that is typically caused by shaking or a strong rotation of a person’s head, which is most commonly seen with Shaken Baby Syndrome, or by rotational forces, such as a car accident. Finally, TBI can be the result of a penetrating injury to the brain occurring from the impact of a bullet, knife or other sharp object that forces hair, skin, bones and fragments from the object into the brain. TBI is the effect of a variation of accidents and incidents.
TBIs can result from any external force or penetrating injury to the head. Here’s what commonly causes TBIs and what victims can do to seek justice after suffering a TBI.
Usefulness of DTI in Traumatic Brain Injury Patients
Traumatic brain injury (TBI) and mild traumatic brain injury (mTBI) are commonly referred to as a concussion. The diagnosis of concussions remains controversial, seeing as how the brain often appears quite normal on conventional computed tomography (CT) and magnetic resonance imaging (MRI) scans. Before-Mentioned conventional tools, still, do not adequately depict brain injury especially in mTBI patients because such conventional tools are not sensitive in detecting diffuse axonal injuries (DAI), also described as traumatic axonal injuries (TAI), which are major brain injuries in mTBI cases. Moreover, 15 to 30 % of those diagnosed with mTBI on the basis of cognitive and clinical symptoms, do not settle following the first three months post-injury. Rather, cognitive and clinical symptoms persist, and in some cases lead to long-term disability.i
DTI and White Matter
White matter disruption is an important determinant of cognitive impairment after brain injury, but, nevertheless, conventional neuroimaging underestimates its extent. Additionally, the relationship between cognitive impairment after traumatic brain injury and white matter damage is somewhat complex. Conventional CT and standard MRI underestimate the extent of white matter damage after traumatic brain injury.ii Standard MRI of traumatic brain injury includes the use of gradient-echo imaging that allows the identification of microbleeds.
Fortunately, it has become possible to study white matter damage using diffusion tensor imaging.iii Diffusion tensor imaging provides a validated and sensitive way of identifying the impact of an axonal injury, as diffuse axonal injury (DAI) is usually recognized in closed head injuries, but a difficult diagnosis for medical personnel to make.
However, DTI data is helpful as it displays the amount of water diffusion in some directions at each point (voxel) in the image. Thus, the DTI metrics can be derived to quantify the degree of white matter disruption, resulting in a much easier diagnosis.iv
Increasing the Effectiveness of DTI in Viewing White Matter
Techniques, such as constrained spherical deconvolution (CSD) have been shown to increase the reliability of fiber tractography. Constrained spherical deconvolution (CSD) is a new technique that, based on high-angular resolution diffusion imaging (HARDI) MR data, estimates the orientation of multiple intravoxel fiber populations within regions of complex white matter architecture, thus overcoming the limitations of the most common diffusion tensor imaging (DTI) technique.v Because a large proportion of brain white matter consists of voxels that contain more than one large fiber bundle, therefore, higher order diffusion models resolve fiber crossings to improve white matter tractography.
If you or a loved one has suffered a traumatic brain injury(TBI) in an accident, it is important that you contact a TBI lawyer at the Amaro Law Firm. We have over 20 years of experience in representing people in personal injury cases, and we can utilize that experience in navigating your case. We will investigate your accident in an attempt to establish who was at fault, and pursue maximum injury compensation by filing an injury claim on your behalf. With help from a TBI attorney at the Amaro Law Firm, you may be able to fully recover damages such as medical bills, therapy expenses, pain and suffering, and lost income without having to pay anything out of pocket.
i Shenton, ME et al. “A Review of Magnetic Resonance Imaging and Diffusion Tensor Imaging Findings in Mild Traumatic Brain Injury.” Brain imaging and behavior 6.2 (2012): 137–192. PMC. Web. 10 July 2015.
ii Rugg-Gunn FJ, Symms MR, Barker GJ, Greenwood R, Duncan JS. Diffusion imaging shows abnormalities after blunt head trauma when conventional magnetic resonance imaging is normal. J Neurol Neurosurg Psychiatry 2001;70:530-3.
iii Assaf Y, Pasternak O. Diffusion tensor imaging (DTI)-based white matter mapping in brain research: A review (Review). J Mol Neurosci 2008;34:51-61.
iv Basser PJ, Pierpaoli C. Microstructural and physiological features of tissues elucidated by quantitative-diffusion-tensor MRI. J Magn Reson B 1996;3:209-19.
v Jeurissen, B., Leemans, A., Jones, D. K., Tournier, J.-D. and Sijbers, J. (2011), Probabilistic fiber tracking using the residual bootstrap with constrained spherical deconvolution. Hum. Brain Mapp., 32: 461–479. doi: 10.1002/hbm.21032.