Abstract
Indroduction
Infantile traumatic brain injury (TBI) rarely follows a biphasic clinical course and exhibits a bright tree appearance (BTA) on magnetic resonance imaging (MRI). This is termed infantile traumatic brain injury with a biphasic clinical course and late reduced diffusion (TBIRD). TBIRD has clinical features similar to those of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). It remains to be clarified which patients with infantile TBI will develop TBIRD and the prevention and treatment of TBIRD.
Case and review
We report a case of TBIRD that exhibited BTA 1 day before the late seizure and review 12 cases of TBIRD. All patients developed a subdural hematoma (SDH), were younger than 2 years, and presented with a biphasic phase within 3–6 days. The median interval between BTA and TBI was 5 days. Of the 5 cases examined with MRI before the biphasic phase, only our case was detected with BTA 4 days after TBI.
Conclusion
Predicting the biphasic clinical course may be possible by examining MRI after TBI in patients under 2 years of age who develop SDH with unconsciousness, seizure, or hemiplegia, and these patients should be strictly followed up for 1 week.
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All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Naoki Kaneko. The first draft of the manuscript was written by Naoki Kaneko, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Kaneko, N., Nishizawa, H., Fujimoto, J. et al. An infantile traumatic brain injury with a bright tree appearance detected before the late seizure. Childs Nerv Syst 39, 285–288 (2023). https://doi.org/10.1007/s00381-022-05589-2
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DOI: https://doi.org/10.1007/s00381-022-05589-2