Figure 1.
Correlations between DTI lesion load and patients’ neurocognitive data.
As demonstrated in the figures, DTI lesion load (both TBSS and VBA data) are significantly correlated with patients’ overall SAC score and delayed recall. R squared values are shown on each figure for linear regression.
Figure 2.
Dot plots demonstrating UCH-L1 and GFAP concentrations.
Serum UCH-L1 (A) and GFAP (B) concentrations on admission in TBI patients and in controls. Error bars represent median and range. Significant differences are indicated with ** (P< 0.01) or *** (P <0.001) (Mann–Whitney U-test).
Figure 3.
Box-and-whisker plots demonstrating UCH-L1 and GFAP concentrations.
(A) Serum UCH-L1 and GFAP concentrations in patients who were victims of assault and in patients injured in a MVA. (B) Serum UCH-L1 and GFAP concentrations in patients with ventricular hemorrhages and hemorrhagic contusions and in patients with non-hemorrhagic lesions. The black horizontal line in each box represents the median, with the boxes representing the interquartile range. Significant differences are indicated * (P< 0.05) or ** (P <0.01) (Mann–Whitney U-test).
Figure 4.
Case 1. MRI and biomarker profile in a patient with intraventricular hemorrhage missed by CT.
Panels a) and b) are SWI images at different locations of the brain showing intra-ventricular blood and left lingual gyrus blood product (see arrows); panel c) is FLAIR image showing non-specific white matter hyper- intensities (see arrows); panel d) is DTI FA map showing the co-existence of voxels with increased and decreased FA measures (red color means FA decrease and blue color FA increase in comparison with controls, t>3 for t-test); and panel e) is blood biomarker temporal profile, which exhibiting extraordinarily high GFAP levels over time in comparison with controls (median 0.004, interquartile range 0.004-0.015). Despite being missed by CT, the injury was still detected by both blood biomarker and MRI.
Figure 5.
Case 2. MRI and biomarker profile in a patient with traumatic axonal injury but normal-appearing structural MRI.
Panels a-d) are MRI images at the corpus callosum and fornix level. Panels e-h) are MRI images at the level of superior coronal radiata. Panel i) is blood biomarker profile. FLAIR and SWI images both indicate the skalp contusion at the parieto-occipital region (long arrows) but normal-appearing brain structure. However, both DTI TBSS and VBA analyses detected significantly reduced FA values at the ipsilateral side (corticospinal tract) and contralateral side (superior corona radiata) of brain white matter (arrow heads), in suggestion of coup and contra coup injury at the microstructure of white matter. Cold color indicates reduced FA values in comparison with controls (t>3 for t-test). Blood biomarkers indicate slightly increased GFAP levels over time but significantly increased UCH-L1 at the admission.