Evidence of TBI
An article in the American Journal of Neuroradiology looked into the use of DTI/MR to study chronic TBI patients. It was assumed that the iron remnants of blood, which is what is seen by the SWI, would or could dissipate over years. However, they found that these microhemorrhage sites arising in the brain after a severe trauma are “time independent,” meaning that they do not fade over time. Another question answered was whether these tiny “tissue tears” in the brain are hemorrhagic or non-hemorrhagic. Studies had determined the answer both ways. The study determined that most but not all microhemorrhages involve a hemorrhagic (blood orientated) aspect.
They also establish that traumatic micro-bleeds are:
Located mainly in the frontal lobe and temporal lobe.
The white matter of the superior frontal gyrus was most often affected.
That the traumatic microbleeds were situated mainly at the gray matter-white matter border. These were further located more often next to the crowns rather than the base of the gyral stalks. Most were bilateral.
Periventricular hyperintensities, (like spots close to the hollow ventricles in the center of our brain), are reported to be present in 74% of young normal persons and 89% of elderly normal persons. Therefore, it is very important for your doctor and lawyer to distinguish these rather common abnormalities from those caused by trauma, particularly by location.
Unfortunately, a comment is made “diffuse axonal injury is usually related to general poor clinical status.” This statement is based on a 1991 paper written prior to even the discovery that DIA occurred in mild TBI. (Scheid R. et al. 2003)
