The effect of aging on the development of cerebral microbleeds after traumatic brain injury: a case report
EANS Academy. Toth L. 09/25/19; 275842; EP05037
Dr. Luca Toth
Dr. Luca Toth

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Abstract
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Traumatic brain injury has been shown to lead to the development of cerebral microbleeds (CMBs) associated with poor outcome, memory defect, depression and cognitive decline. Although the elderly are especially prone to suffer TBI, but the effect of ageing on the number and distribution of CMBs is not well understood. In this case presentation we demonstrate the characteristics of TBI-induced CMBs in patients from different age groups after moderate TBI.
Four patients' medical history and susceptibility weighted MR images were analysed afterward the lesions were localised according to a Brain White Matter Atlas. Two patients suffered moderate traumatic brain injury (age 40 male and 60 years male), and two aged matched (39 years, male and 66 years, female) healthy controls without TBI were enrolled retrospectively into the study.
In case of the 40 years old patient, 2 lesions were found in the temporal lobe, one in the subcortical area, the other one in the subcortical white matter, Adam's grade I. The age matched control patient had no CMB on the SWI MRI. In the brain of the 60 years old patient multiple lesions were identified, 5 lesions forming a group in the temporal region, further seven lesions in the occipical-, frontal lobes, parieto-occipital border, fronto-parietal border and lesion in gyrus postcentralis along with two CMBs in the brainstem, a macrobleeding was found too, overall Adam's classification Grade III. 1 lesion was diagnosed in the frontal subcortical white matter region in the aged matched control patient.
Further prospective studies are needed to establish the link between ageing and microbleed formation after TBI and the clinical relevance of TBI-related CMBs in the elderly.
Traumatic brain injury has been shown to lead to the development of cerebral microbleeds (CMBs) associated with poor outcome, memory defect, depression and cognitive decline. Although the elderly are especially prone to suffer TBI, but the effect of ageing on the number and distribution of CMBs is not well understood. In this case presentation we demonstrate the characteristics of TBI-induced CMBs in patients from different age groups after moderate TBI.
Four patients' medical history and susceptibility weighted MR images were analysed afterward the lesions were localised according to a Brain White Matter Atlas. Two patients suffered moderate traumatic brain injury (age 40 male and 60 years male), and two aged matched (39 years, male and 66 years, female) healthy controls without TBI were enrolled retrospectively into the study.
In case of the 40 years old patient, 2 lesions were found in the temporal lobe, one in the subcortical area, the other one in the subcortical white matter, Adam's grade I. The age matched control patient had no CMB on the SWI MRI. In the brain of the 60 years old patient multiple lesions were identified, 5 lesions forming a group in the temporal region, further seven lesions in the occipical-, frontal lobes, parieto-occipital border, fronto-parietal border and lesion in gyrus postcentralis along with two CMBs in the brainstem, a macrobleeding was found too, overall Adam's classification Grade III. 1 lesion was diagnosed in the frontal subcortical white matter region in the aged matched control patient.
Further prospective studies are needed to establish the link between ageing and microbleed formation after TBI and the clinical relevance of TBI-related CMBs in the elderly.
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