Abstract
IntroductionTraumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head. Specifically, mild traumatic brain injury is a clinical diagnosis that can have significant effects on an individual's life, yet is difficult to identify through traditional imaging techniques.Case presentationThis is the case of a 68-year-old previously healthy African American woman who was involved in a motor vehicle accident that resulted in significant head trauma. After the accident, she experienced symptoms indicative of mild traumatic brain injury and sought a neurological consultation when her symptoms did not subside. She was initially evaluated with a neurological examination, psychological evaluation, acute concussion evaluation and a third-party memory test using software from CNS Vital Signs for neurocognitive function. A diagnosis of post-concussion syndrome was suggested. Diffusion tensor imaging revealed decreased fractional anisotropy in the region immediately adjacent to both lateral ventricles, which was used to confirm the diagnosis. Fractional anisotropy is a scalar value between zero and one that describes the degree of anisotropy of a diffusion process. These results are indicative of post-traumatic gliosis and are undetectable by magnetic resonance imaging. Our patient was treated with cognitive therapy.ConclusionMinor traumatic brain injury is a common injury with variable clinical presentation. The system of diagnosis used in this case found a significant relationship between the clinical assessment and imaging results. This would not have been possible using traditional imaging techniques and highlights the benefits of using diffusion tensor imaging in the sub-acute assessment of minor traumatic brain injury.
Highlights
Traumatic brain injury is a form of acquired brain injury that results from sudden trauma to the head
Minor traumatic brain injury is a common injury with variable clinical presentation
We examined our patient’s symptoms on various levels to fully understand the utility of diffusion tensor imaging (DTI) in patients with mild TBI (MTBI)
Summary
MTBI is a significant issue in the United States, as it results in chronic effects in 1.7 million people each year. A cost efficient, systematic method of diagnosing MTBI could serve the individual and the medical community through increasing specificity of care, leading to a reduction in the amount of time that an individual is not able to work. This increase in treatment specificity and increased quality of care as a secondary prevention strategy is important from a public health perspective. In this case, DTI served as a powerful diagnostic tool, providing imaging results that offered an explanation for our patient’s clinical picture. A copy of the written consent is available for review by the Editor-in-Chief of this journal
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