Magnetic Resonance Elastography in Patients With Acute Closed Traumatic Brain Injury

Study Overview
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Brief Summary
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Traumatic brain injury (TBI) is a major public health issue, and intracranial hypertension in the acute phase remains a critical scientific issue. Many patients with acute closed TBI received conservative, non-surgical treatments at first, while 5% 19% of which develops intractable intracranial hypertension that requires emergent surgery. Therefore, it is of great clinical significance to identify patients who are at high risk of deterioration in the early stage. Previous studies have found that brain compliance is a contributive factor to intracranial pressure, and might serve in the development of intracranial hypertension after TBI. We made assumption that intracranial pressure has a negative relationship with brain compliance providing that the volume of hematoma remains constant. However, few studies have applied magnetic resonance elastography (MRE) in evaluating brain compliance in patients with TBI. Therefore, this study is designed to enroll patients with acute closed traumatic brain injury who are initially treated non-surgically. Magnetic resonance elastography (MRE) sequences are performed to non-invasively assess patients' brain compliances, in the hope of exploring the potential value of MRE biomarkers to predict the short-term outcome in patients with acute closed TBI who are initially receive non-surgical treatments.

Official Title
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Prediction of Short-term Outcome in Patients With Acute Closed Traumatic Brain Injury Using Magnetic Resonance Elastography

Conditions
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Traumatic Brain Injury

Intervention / Treatment
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* Diagnostic Test: Magnetic resonance elastography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18-60 years old Acute closed traumatic brain injury within 7 days Not receiving surgical intervention according to the judgement of neurosurgeons Expected tolerance of magnetic resonance imaging (MRI) scan 7 days from injury Exclusion Criteria: Vital organ failure: congestive heart failure, respiratory failure, renal failure (CKD≥stage 3), severe hepatic dysfunction (Child-Pugh stage B or C) Any central nervous system (CNS) pathology prior to injury: stroke, epilepsy, CNS tumour/infections, dementia or other neurodegenerative diseases CT reveals infratentorial hematoma Contraindications of MRI Currently enrolled in other researches

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>All patients enrolled in the study will be in this group. | Diagnostic Test: Magnetic resonance elastography<br>* All patients enrolled will receive magnetic resonance elastography of the brain.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 14-day ΔGCS | Change of Glasgow Coma Scale (GCS) 14 days after injury from GCS at admission. The GCS is a indication of patient's conscious status, ranging from 3 (poor) to 15 (good). | 14 days after injury | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 14-day mortality | All-cause mortality within 14 days from injury. | 14 days after injury | 
| 14-day emergent surgery | Emergent surgery due to intracranial pathology within 14 days from injury. The decision of emergent surgery (evacuation of newly emerged hematoma, decompressive craniectomy due to refractory intracranial hypertension, etc) is determined by attending neurosurgeon. | 14 days after injury | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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traumatic brain injury, magnetic resonance elastography, brain compliance