Valoración del daño axonal difuso en los traumatismos cráneo-encefálicos

Carmen Junqué

doi:10.24310/espsiescpsi.v2i1.13359

Authors

Carmen Junqué Departament de Psiquiatria i Psicobiologia Clínica. Universitat de Barcelona. Spain

DOI:

https://doi.org/10.24310/espsiescpsi.v2i1.13359

Keywords:

Traumatic brain injury, diffuse axonal injury, magnetic resonance imaging, diffusion tensor imaging

Abstract

Diffuse axonal injury (DAI) in traumatic brain injury (TBI) is produced by primary and secondary mechanisms of axonal damage. DAI is the responsible of neuropsychological impairments associated to moderate and diffuse TBI such as deficits in attention, memory, speed of mental processing and executive functions. Clinical magnetic resonance imaging allows to identify traumatic microbleeds using T2* and to quantify indirect signs of DAI such as the ventricular volumes of corpus callosum surface. Diffusion tensor imaging (DTI) is the most suitable technique to identify and to quantify DAI in TBI patients. The fractional anisotropy (FA) values have been found sensitive to DAI even in mild TBI and correlate with severity parameters such as Glasgow coma scale and post-traumatic amnesia. FA values changes over time but it remains as a permanent TBI sequel even in children. The mean whole brain FA and corpus callosum measures have shown significant correlations with the classical neuropsychological deficits seen in TBI patients with DAI.

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