MR-BASED BRAIN AND CEREBROSPINAL-FLUID MEASUREMENT AFTER TRAUMATIC BRAIN INJURY - CORRELATION WITH NEUROPSYCHOLOGICAL OUTCOME

PURPOSE: To determine the magnitude and time course of changes in the Volume of brain and intracranial cerebrospinal fluid (CSF) spaces in p atients who have sustained traumatic brain injury and to assess the re lationship between these findings and long-term cognitive outcome. MET HODS: Axial intermediate and T2-weighted MR images of 123 patients wit h traumatic brain injury were quantified using a multispectral segment ation algorithm. Measurements were corrected for differences in age, s ex, and head size using a previously reported normative database. Brai n morphology was compared across groups formed on the basis of chronic ity of injury. Cognitive functioning and severity of injury were stati stically correlated with brain measurements. RESULTS: Time-dependent e xpansion of CSF spaces and decreases in brain volume were observed. In creases in Ventricular CSF volume, particularly in the temporal horns and third ventricle, preceded subsequent changes in total brain and su barachnoid CSF. High and moderate correlation was observed between Vol ume measures and cognitive outcome and injury severity. Particularly s trong was the relation between the volume of the left temporal horn an d Verbal IQ scores. CONCLUSION: Predictable time-dependent atrophic ch anges occurring after traumatic brain injury can be quantified using M R volumetric studies. Our results suggest significant contributions by both diffuse and focal mechanisms of injury. In the postacute period (more than 70 days after injury), MR volumetric studies may be predict ive of eventual cognitive outcome.