Traumatic microbleeds persist for up to five years following traumatic brain injury despite resolution of other acute findings on MRI.
Theresa Rizk, L Christine Turtzo, Martin Cota and 4 others
PMID 32228304WHAT IT FOUND
Tiny bleeding spots seen on MRI within 48 hours of traumatic brain injury persisted in 15 of 18 patients at one year and all later scans, while many other acute MRI findings resolved.
Key findings
01Tiny bleeding spots seen on acute MRI persisted in 15 of 18 patients at one year and on all later scans.
02Other acute findings often changed by one year: all 17 diffusion MRI lesions resolved, and only 6 of 24 extra-axial hemorrhages remained observable.
03Microbleeds were seen across mild, moderate, and severe TBI: 2 of 7 mild, 15 of 19 moderate, and 3 of 4 severe.
STILL TO COME
How it was doneWhat they found
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What it does not show
Only 30 patients were analysed, and not all completed every follow-up scan, so the persistence finding may not apply to all people with TBI. The study did not report a statistical link between microbleeds and clinical outcome, so it cannot show what persistent microbleeds mean for patients. Acute and follow-up scans were done on different scanners and at different sites, and two new microbleeds appeared only after follow-up scans at 3T. The sample included 7 patients with mild TBI, 19 with moderate TBI, and 4 with severe TBI. This is a small number for mild TBI. Without scans before injury, some microbleeds could have been present before the TBI.
Declared interests
The supplied article text does not report a conflict-of-interest or funding statement. The metadata lists non-U.S. government research support.
The easy way to misread this
Do not conclude that persistent microbleeds cause disability or that MRI should be used routinely to guide therapy. The study had 30 patients, no clinical outcome analysis, scanner differences, and incomplete follow-up.