In traumatic brain injury, white matter diffusion restriction can be an imaging manifestation of non-hemorrhagic axonal injury. In this article, a different pattern of widespread white matter diffusion restriction associated with ipsilateral cortical damage, all noted in pediatric and young adult TBI patients, is presented. Its atypical pattern of distribution and extensive scope on imaging suggest excitotoxicity and intramyelinic edema as possible underlying mechanisms.
YuanLWeiXXuC, et al.Use of multisequence 3.0-T MRI to detect severe traumatic brain injury and predict the outcome. Br J Radiol2015; 88: 20150129.
6.
LeeHWintermarkMGeanAD, et al.Focal lesions in acute mild traumatic brain injury and neurocognitive outcome: CT versus 3T MRI. J Neurotrauma2008; 25: 1049–1056.
7.
KurlandDHongCAarabiB, et al.Hemorrhagic progression of a contusion after traumatic brain injury: a review. J Neurotrauma2012; 29: 19–31.
8.
EdlowBLGiacinoJTHirschbergRE, et al.Unexpected recovery of function after severe traumatic brain injury: the limits of early neuroimaging-based outcome prediction. Neurocritical Care2013; 19: 364–375.
9.
MuccioCFDe SimoneMEspositoG, et al.Reversible post-traumatic bilateral extensive restricted diffusion of the brain. A case study and review of the literature. Brain Inj2009; 23: 466.
10.
ElliottCARamaswamyVJacobFD, et al.Early diffusion restriction of white matter in infants with small subdural hematomas is associated with delayed atrophy. Childs Nerv Syst2017; 33: 289–295.
11.
BiousseVSuhDYNewmanNJ, et al.Diffusion-weighted magnetic resonance imaging in shaken baby syndrome. Am J Ophthalmol2002; 133: 249–255.
12.
LiuAYMaldjianJABagleyLJ, et al.Traumatic brain injury: diffusion-weighted MR imaging findings. AJNR Am J Neuroradiol1999; 20: 1636–1641.
13.
HerganKSchaeferPWSorensenAG, et al.Diffusion-weighted MRI in diffuse axonal injury of the brain. Eur Radiol2002; 12: 2536–2541.
14.
TopalNBHakyemezBErdoganC, et al.MR imaging in the detection of diffuse axonal injury with mild traumatic brain injury. Neurol Res2008; 30: 974–978.
15.
Al BrashdiYHAlbayramMS. Reversible restricted-diffusion lesion representing transient intramyelinic cytotoxic edema in a patient with traumatic brain injury. NeuroRadiol J2015; 28: 409–412.
16.
MoritaniTSmokerWRSatoY, et al.Diffusion-weighted imaging of acute excitotoxic brain injury. AJNR Am J Neuroradiol2005; 26: 216–228.
17.
TehseJTaghibiglouC. The overlooked aspect of excitotoxicity: glutamate-independent excitotoxicity in traumatic brain injuries. Eur J Neurosci2019; 49: 1157–1170.
18.
LiptonSARosenbergPA. Excitatory amino acids as a final common pathway for neurologic disorders. N Engl J Med1994; 330: 613–622.
19.
Bekiesinska-FigatowskaMDuczkowskaASzkudlinska-PawlakS, et al.Diffusion restriction in the corticospinal tracts and the corpus callosum in neonates after cerebral insult. Brain Dev2017; 39: 203–210.
20.
HayakawaKTandaKNishimuraA, et al.Diffusion restriction in the corticospinal tract and the corpus callosum of term neonates with hypoxic-ischemic encephalopathy. Pediatr Radiol2022; 52: 1356–1369.
21.
MazumdarAMukherjeePMillerJH, et al.Diffusion-weighted imaging of acute corticospinal tract injury preceding Wallerian degeneration in the maturing human brain. AJNR Am J Neuroradiol2003; 24: 1057–1066.
22.
JohnstonMV. Neurotransmitters and vulnerability of the developing brain. Brain Dev1995; 17: 301–306.
23.
BarzóPMarmarouAFatourosP, et al.Contribution of vasogenic and cellular edema to traumatic brain swelling measured by diffusion-weighted imaging. J Neurosurg1997; 87: 900–907.
24.
UnterbergAWStoverJKressB, et al.Edema and brain trauma. Neuroscience2004; 129: 1021–1029.
25.
ZhuoJXuSProctorJL, et al.Diffusion kurtosis as an in vivo imaging marker for reactive astrogliosis in traumatic brain injury. Neuroimage2012; 59: 467–477.
26.
SoniNMohamedAZKurniawanND, et al.Diffusion magnetic resonance imaging unveils the spatiotemporal microstructural gray matter changes following injury in the rodent brain. J Neurotrauma2019; 36: 1306–1317.
27.
StevenAJZhuoJMelhemER. Diffusion kurtosis imaging: an emerging technique for evaluating the microstructural environment of the brain. AJR Am J Roentgenol2014; 202: W26–W33.
28.
NakayamaYAokiYNiitsuH. Studies on the mechanisms responsible for the formation of focal swellings on neuronal processes using a novel in vitro model of axonal injury. J Neurotrauma2001; 18: 545–554.
29.
BuddeMDFrankJA. Neurite beading is sufficient to decrease the apparent diffusion coefficient after ischemic stroke. Proc Natl Acad Sci USA2010; 107: 14472–14477.
