Magnetic Resonance (MR) Spectroscopy and Diffusion Tensor Imaging in Determining Brain Injury and Subsequent Clinical Outcome in Patients of Moderate Brain Trauma
Magnetic Resonance (MR) Spectroscopy and Diffusion Tensor Imaging in Determining Brain Injury and Subsequent Clinical Outcome in Patients of Moderate Brain Trauma
The purpose of this study is to use magnetic resonance spectroscopy (MRS) and diffusion
 tensor imaging (DTI) to assess for traumatic brain injury and determine if there is any
 correlation of these findings to clinical outcome. MR spectroscopy using 2D-CSI (a multi
 voxel technique) of the corpus callosum, basal ganglia, lobar white matter and brainstem may
 reveal areas of injury and quantification of the metabolites from these areas may be used to
 correlate with imaging findings and clinical evaluation. White matter disruption in these
 areas is commonly seen after TBI, caused by diffuse axonal injury. It has been implicated in
 the long term outcomes in these patients, but has been difficult to assess by standard
 radiologic studies.

 By the use of DTI it may be possible to demonstrate damaged white matter tracts which could
 be helpful in the evaluation of traumatic brain injury. Most TBI subjects have injuries that
 involved torque to the brain. This results in a shearing injury to the long white matter
 tracts, which has been hypothesized to be related to cognitive outcome.

 Also, to demonstrate that MRS and DTI prove valuable in predicting outcome in patients of
 moderate brain trauma by conducting progressive studies acutely (within 24 hours) and long
 term (4-6 weeks). Most patients will most likely be followed clinically for over a year, and,
 if clinical indicated, farther scanning can be done at a later date.

 By comparing fraction anisotropy, ADC values, and metabolic ratios by the use of DTI and MRS
 in the adult and pediatric populations, may help to assess differences in recovery.

 Lastly, a comparison between the two groups in changes in brain metabolism and/or white
 matter tract disruption/re-connection after TBI with and/or without links to outcome can be
 done.
The purpose of this study is to determine if MRI imaging can accurately detect the clinical
 outcome (extent of recovery) of patients who have moderate to severe brain injury. This study
 may show that MRI can provide a clearer picture on the extent of the brain injury and help
 medical physicians decide how to best treat these patients with a more accurate idea of the
 brain function of the recovering patient.
Inclusion Criteria:

 -  Patients of acute moderate brain trauma

 Exclusion Criteria:

 -  Patients who are medically unstable or have CT findings that may interfere with the
 study such as:

 -  a large hemorrhage or edema

 -  encephalomalacia

 -  prior neurosurgeries

 -  hardware placed in the head or neck

 -  prior head trauma

 -  history of neurological conditions