Stories about: traumatic brain injury

Brain structural imaging: Gleaning more with math

MRI images showing isotropic diffusion in autism
A new MRI computational technology (above right) captures differences in water diffusion in the brain across a population of children with autism as compared with controls. This non-directional, “isotropic” diffusion pattern, not evident with conventional diffusion tensor imaging (DTI), may be an indicator of brain inflammation.

Diffusion tensor imaging (DTI), a form of magnetic resonance imaging, has become popular in neuroscience. By analyzing the direction of water diffusion in the brain, it can reveal the organization of bundles of nerve fibers, or axons, and how they connect—providing insight on conditions such as autism.

But conventional DTI has its limits. For example, when fibers cross, DTI can’t accurately analyze the signal: the different directions of water flow effectively cancel each other out. Given that an estimated 60 to 90 percent of voxels (cubic-millimeter sections of brain tissue) contain more than one fiber bundle, this isn’t a minor problem. In addition, conventional DTI can’t interpret water flow that lacks directionality, such as that within the brain’s abundant glial cells or the freely diffusing water that results from inflammation—so misses part of the story.

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Their bodies are broken. What about their brains? Traumatic brain injuries after the marathon bombing.

Boston Marathon bombing memorialIn the hours and days following the Boston Marathon bombings, the first concern for the victims was literally life and limb—stabilizing the survivors and treating wounds suffered in the blasts.

But as the survivors begin the road to recovery—a road that promises to be long and complicated—subtler effects of the blast may become apparent, including traumatic brain injuries (TBIs).

“The difference between traumatic brain injuries and the other injuries we’ve seen is that the extent of other injuries can be readily seen,” says Mark Proctor, MD, a neurosurgeon and director of Boston Children’s Brain Injury Center. “You can have a traumatic brain injury without any external signs.”

TBIs have been a major concern among soldiers serving in war zones like Iraq or Afghanistan who have experienced the concussive force of bomb or improvised explosive device (IED) explosions—not unlike the explosions on Marathon Monday.

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The sobering science of repeat concussions

The atrophied brain of chronic traumatic encephalopathy -- the result of cumulative concussions. (Courtesy Ann McKee)

At a May 18 conference on sports concussion and spinal injury, organized by Boston Children’s Hospital and Harvard Medical School, former hockey player Dan LaCouture and former New England Patriots player Ted Johnson told poignant stories of playing through multiple repeat concussions. I realize their cases are pretty extreme, but my overriding feeling as a parent was horror.

The effects of concussion were first medically described in 1928, in “punch drunk” boxers. Neuropathologist Ann McKee, MD, of Boston University and the Veteran’s Administration does brain autopsies for a living, and showed us the atrophied brains of ex-NFL players like John Grimsley and Dave Duerson. Both have abnormal deposits of a protein called tau. That’s the hallmark of a neurodegenerative brain disorder called chronic traumatic encephalopathy, or CTE.

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Treating traumatic brain injury with a nasal spray?

Could an extract from this Chinese club moss have a neuroprotective effect?

Severe traumatic brain injury — such as that associated with military head wounds — is basically untreatable. In addition to cognitive and motor impairments, it leads to epilepsy about 20 to 50 percent of the time; anticonvulsants given after trauma have been tried as a preventative but have not worked. “After head trauma, physicians often watch symptoms evolve, and there’s nothing we can do to prevent them,” says Alexander Rotenberg, a neurologist and neurobiology investigator at Children’s Hospital Boston.

The brain damage begins within seconds of the actual trauma, but a punishing series of biochemical events in the brain unfold over the subsequent days and weeks, making matters worse

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