| Title |
Revisiting Grade 3 Diffuse Axonal Injury: Not All Brainstem Microbleeds are Prognostically Equal
|
|---|---|
| Published in |
Neurocritical Care, May 2017
|
| DOI | 10.1007/s12028-017-0399-2 |
| Pubmed ID | |
| Authors |
Saef Izzy, Nicole L. Mazwi, Sergi Martinez, Camille A. Spencer, Joshua P. Klein, Gunjan Parikh, Mel B. Glenn, Steven M. Greenberg, David M. Greer, Ona Wu, Brian L. Edlow |
| Abstract |
Recovery of functional independence is possible in patients with brainstem traumatic axonal injury (TAI), also referred to as "grade 3 diffuse axonal injury," but acute prognostic biomarkers are lacking. We hypothesized that the extent of dorsal brainstem TAI measured by burden of traumatic microbleeds (TMBs) correlates with 1-year functional outcome more strongly than does ventral brainstem, corpus callosal, or global brain TMB burden. Further, we hypothesized that TMBs within brainstem nuclei of the ascending arousal network (AAN) correlate with 1-year outcome. Using a prospective outcome database of patients treated for moderate-to-severe traumatic brain injury at an inpatient rehabilitation hospital, we retrospectively identified 39 patients who underwent acute gradient-recalled echo (GRE) magnetic resonance imaging (MRI). TMBs were counted on the acute GRE scans globally and in the dorsal brainstem, ventral brainstem, and corpus callosum. TMBs were also mapped onto an atlas of AAN nuclei. The primary outcome was the disability rating scale (DRS) score at 1 year post-injury. Associations between regional TMBs, AAN TMB volume, and 1-year DRS score were assessed by calculating Spearman rank correlation coefficients. Mean ± SD number of TMBs was: dorsal brainstem = 0.7 ± 1.4, ventral brainstem = 0.2 ± 0.6, corpus callosum = 1.8 ± 2.8, and global = 14.4 ± 12.5. The mean ± SD TMB volume within AAN nuclei was 6.1 ± 18.7 mm(3). Increased dorsal brainstem TMBs and larger AAN TMB volume correlated with worse 1-year outcomes (R = 0.37, p = 0.02, and R = 0.36, p = 0.02, respectively). Global, callosal, and ventral brainstem TMBs did not correlate with outcomes. These findings suggest that dorsal brainstem TAI, especially involving AAN nuclei, may have greater prognostic utility than the total number of lesions in the brain or brainstem. |
X Demographics
The data shown below were collected from the profiles of 10 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 3 | 30% |
| United Kingdom | 1 | 10% |
| Argentina | 1 | 10% |
| Spain | 1 | 10% |
| Unknown | 4 | 40% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 9 | 90% |
| Science communicators (journalists, bloggers, editors) | 1 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 73 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 73 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 11 | 15% |
| Student > Bachelor | 8 | 11% |
| Student > Doctoral Student | 7 | 10% |
| Student > Ph. D. Student | 5 | 7% |
| Other | 4 | 5% |
| Other | 13 | 18% |
| Unknown | 25 | 34% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 28 | 38% |
| Neuroscience | 11 | 15% |
| Nursing and Health Professions | 3 | 4% |
| Engineering | 2 | 3% |
| Psychology | 1 | 1% |
| Other | 1 | 1% |
| Unknown | 27 | 37% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 August 2018.
All research outputs
#4,725,840
of 22,968,808 outputs
Outputs from Neurocritical Care
#443
of 1,505 outputs
Outputs of similar age
#83,078
of 310,732 outputs
Outputs of similar age from Neurocritical Care
#4
of 29 outputs
Altmetric has tracked 22,968,808 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,505 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.4. This one has gotten more attention than average, scoring higher than 70% of its peers.
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We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 86% of its contemporaries.