Susceptibility-Weighted Magnetic Resonance Imaging (MRI) of Microbleeds in Pediatric Concussion.

Shane Virani,Keith Owen Yeates,Bradley G Goodyear,Brian L Brooks,Alexander Barton

doi:10.1177/08830738211002946

Abstract

Objective:The long-term consequences of pediatric concussion on brain structure are poorly understood. This study aimed to evaluate the presence and clinical significance of cerebral microbleeds several years after pediatric concussion.Methods:Children and adolescents 8-19 years of age with either a history of concussion (n = 35), or orthopedic injury (n = 20) participated. Mean time since injury for the sample was 30.4 months (SD = 19.6). Participants underwent susceptibility-weighted imaging, rated their depression and postconcussion symptoms, and completed cognitive testing. Parents of participants also completed symptom ratings for their child. Hypointensities in susceptibility-weighted images indicative of cerebral microbleeds were calculated as a measure of hypointensity burden.Results:Hypointensity burden did not differ significantly between participants with a history of concussion and those with a history of orthopedic injury. Depression ratings (self and parent report), postconcussion symptom ratings (self and parent report), and cognitive performance did not significantly correlate with hypointensity burden in the concussion group.Conclusions:These findings suggest that at approximately 2.5 years postinjury, children and adolescents with prior concussion do not have a greater amount of cerebral microbleeds compared to those with orthopedic injury. Future research should use longitudinal study designs and investigate children with persistent postconcussive symptoms to gain better insight into the long-term effects of concussion on cerebral microbleeds.

Highlights

Background historyParents of participants completed a form that collected demographic information and background history
The present study is the first to investigate the presence of cerebral microbleeds years after pediatric concussion in order to improve our understanding of the long-term impact of these injuries
The results provide evidence that, at approximately 2.5 years postinjury, children and adolescents who sustain a concussion do not have an increased hypointensity burden compared to children and adolescents who sustain an orthopedic injury

Summary

Introduction

Parents of participants completed a form that collected demographic information and background history This form included: date of most recent injury, number of previously diagnosed concussions, injury details regarding loss of consciousness and posttraumatic amnesia, and diagnoses of attention-deficit hyperactivity disorder (ADHD), learning disability, mood disorder, and migraine. Susceptibility-weighted imaging data were acquired using a gradient echo pulse sequence with an effective echo time (TE) of 23 ms, a repetition time (TR) of 54 ms, and a flip angle of 15 degrees. T1-weighted anatomical images were acquired using GE’s BRAVO sequence with a TE/TR of 8.2/3.1 ms, an inversion time of 600 ms, a flip angle 10 degrees, an FOV of 220 Â 220 mm, and a voxel size of 0.86 Â 0.86 Â 0.8 mm[3]

Methods

Results

Conclusion