Neuroimaging clinics of North America
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Conventional neuroimaging examinations are typically normal in concussed young athletes. A current focus of research is the characterization of subtle abnormalities after concussion using advanced neuroimaging techniques. ⋯ In the future, such biomarkers will likely provide important clinical information regarding the appropriate time interval before return to play, as well as the risk for prolonged postconcussive symptoms and long-term cognitive impairment. This article discusses results from advanced imaging techniques and emphasizes imaging modalities that will likely become available in the near future for the clinical evaluation of concussed young athletes.
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In the United States alone, 1.6 to 3.8 million people have sports-related concussions yearly. The patho-mechanisms of concussions may not be directly measured by conventional neuroimaging; advanced models may be needed to address the shortcomings of the current clinical protocols. Multimodal advanced imaging may provide more accurate diagnosis and predict the clinical course of concussion, assessing the efficacy of existing and emerging multifaceted therapies. In this article, the authors present an overview and pictorial display of conventional and advanced multimodal MR imaging methods that have been applied to identify the brain structures affected in traumatic brain injuries.
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Neuroimaging Clin. N. Am. · Feb 2018
ReviewSusceptibility-Weighted Imaging and Magnetic Resonance Spectroscopy in Concussion.
Although susceptibility-weighted imaging (SWI) studies have suggested an increased number of microhemorrhages in concussion, most show no significant differences compared with controls. There have been mixed results on using SWI to predict neurologic outcomes. ⋯ Applications in individual patients are impeded by conflicting data and lack of consensus on an optimal protocol. Therefore, currently MRS has most utility in group-level comparisons designed to reveal the pathophysiology of concussion.
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Neuroimaging Clin. N. Am. · Nov 2017
ReviewApplication of Resting State Functional MR Imaging to Presurgical Mapping: Language Mapping.
Resting state functional MR imaging (rs-fMR imaging) has become an indispensable tool for examining brain function. The greatest opportunity to translate rs-fMR imaging from the research domain into clinical use is as a tool for examining intrinsic brain networks for preoperative planning. Many studies have demonstrated concordance of intrinsic motor networks from rs-fMR imaging data with task-fMR imaging and direct cortical stimulation. Earlier reports show concordance of language networks as well, although more recent studies with larger numbers of subjects demonstrate subject-level variability that needs to be further investigated and addressed before widespread implementation of rs-fMR imaging for preoperative planning.