Summary
We used low field magnetic resonance imaging and Gadolinium-DTPA to study 10 recently head injured patients. On the pre-contrast images we identified 36 abnormalities in 9 of the 10 patients. After contrast enhancement was seen in 9 of these lesions in 3 patients imaged 5–6 days after injury. Altered blood brain barrier permeability to gadolinium was not seen in 6 patients studied within 4 days of trauma. We did not identify any lesions with gadolinium that were not present on the pre-contrast images.
We do not think that the routine use of contrast in head injury is justified since clinically important lesions will be present on routine sequences. However the use of gadolinium may provide information about the nature and timing of the underlying pathophysiological changes. In human head injury cytotoxic oedema occurs early and vasogenic oedema does not occur until 5–6 days after injury.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Adams JH, Gennarelli TA, Graham DI (1982) Brain damage in non missile head injury: observations in man and subhuman primates. In: Smith WT, Cavanagh JB (eds) Recent advances in neuropathology, Vol 2 Chap 7. Churchill Livingstone, Edinburgh London
Brasch RC (1983) Work in progress: methods of contrast enhancement for NMR imaging and potential applications. Radiology 147: 781–788
Bullock R, Statham P, Patterson J et al (1989) Tomographie mapping of CBF, CBV and blood-brain barrier changes in humans after focal head injury using SPECT-mechanisms for late deterioration. In: Hoff JT, Betz AL (eds) Intracranial pressure VII. Springer, Berlin Heidelberg New York, pp 637–639
Caille JM, Lemanceau B, Bonnemain B (1981) Gadolinium as a contast agent for NMR. AJNR 2: 517–526
Klatzo I, Wisniewski H, Steinwall O et al (1967) Dynamics of cold injury oedema. In: Klatzo I, Seitelberger F (eds) Brain oedema. Springer, New York, p 554
Klatzo I (1976) Neuropathological aspects of brain oedema. J Neuropathol Exp Neurol 26: 1
Mauser HW, Van Nieuwenhuizen O, Veiga Pires JA (1984) Is contrast enhanced CT indicated in acute head injury? Neuroadiology 26: 31–32
McNamara MT (1987) Paramagnetic contrast media for magnetic resonance imaging of the central nervous system. In: Brant-Zawadzki M, Norman D (eds) Magnetic resonance imaging of the central nervous system. Raven Press, New York, pp 97–107
Teasdale G, Murray G, Parker L et al (1979) Adding up the Glasgow Coma Score. Acta Neurochir (Wien) [Suppl] 28: 13–16
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1990 Springer-Verlag
About this paper
Cite this paper
Lang, D.A., Hadley, D.M., Teasdale, G.M., Macpherson, P., Teasdale, E. (1990). Gadolinium-DTPA Enhanced Magnetic Resonance Imaging in Human Head Injury. In: Reulen, HJ., Baethmann, A., Fenstermacher, J., Marmarou, A., Spatz, M. (eds) Brain Edema VIII. Acta Neurochirurgica, vol 51. Springer, Vienna. https://doi.org/10.1007/978-3-7091-9115-6_99
Download citation
DOI: https://doi.org/10.1007/978-3-7091-9115-6_99
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-9117-0
Online ISBN: 978-3-7091-9115-6
eBook Packages: Springer Book Archive