{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:04:24Z","timestamp":1792227864034,"version":"4.4.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"22","license":[{"start":{"date-parts":[[2021,11,1]],"date-time":"2021-11-01T00:00:00Z","timestamp":1635724800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>\n                    Magnetic resonance imaging (MRI) is used rarely in the acute evaluation of traumatic brain injury (TBI) but may identify findings of clinical importance not detected by computed tomography (CT). We aimed to characterize the association of cytotoxic edema and hemorrhage, including traumatic microbleeds, on MRI obtained within hours of acute head trauma and investigated the relationship to clinical outcomes. Patients prospectively enrolled in the Traumatic Head Injury Neuroimaging Classification study (NCT01132937) with evidence of diffusion-related findings or hemorrhage on neuroimaging were included. Blinded interpretation of MRI for diffusion-weighted lesions and hemorrhage was conducted, with subsequent quantification of apparent diffusion coefficient (ADC) values. Of 161 who met criteria, 82 patients had conspicuous hyperintense lesions on diffusion-weighted imaging (DWI) with corresponding regions of hypointense ADC in proximity to hemorrhage. Median time from injury to MRI was 21 (10\u201330) h. Median ADC values per patient grouped by time from injury to MRI were lowest within 24\u2009h after injury. The ADC values associated with hemorrhagic lesions are lowest early after injury, with an increase in diffusion during the subacute period, suggesting transformation from cytotoxic to vasogenic edema during the subacute post-injury period. Of 118 patients with outcome data, 60 had Glasgow Outcome Scale Extended scores \u22646 at 30\/90 days post-injury. Cytotoxic edema on MRI (odds ratio [OR] 2.91 [1.32\u20136.37],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.008) and TBI severity (OR 2.51 [1.32\u20134.74],\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.005) were independent predictors of outcome. These findings suggest that in patients with TBI who had findings of hemorrhage on CT, patients with DWI\/ADC lesions on MRI are more likely to do worse.\n                  <\/jats:p>","DOI":"10.1089\/neu.2021.0037","type":"journal-article","created":{"date-parts":[[2021,9,20]],"date-time":"2021-09-20T01:44:25Z","timestamp":1632102265000},"page":"3107-3118","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":24,"title":["Cytotoxic Edema Associated with Hemorrhage Predicts Poor Outcome after Traumatic Brain Injury"],"prefix":"10.1177","volume":"38","author":[{"given":"L. Christine","family":"Turtzo","sequence":"first","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Luby","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neekita","family":"Jikaria","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison Diane","family":"Griffin","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Greenman","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinoud P.H.","family":"Bokkers","sequence":"additional","affiliation":[{"name":"Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunjan","family":"Parikh","sequence":"additional","affiliation":[{"name":"R Adams Shock Trauma Center and University of Maryland School of Medicine, Baltimore, Maryland, USA."},{"name":"Division of Neurocritical Care and Emergency Neurology, University of Maryland School of Medicine, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Peterkin","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Whiting","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence L.","family":"Latour","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA."},{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,11,2]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nec.2016.05.008"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2018.08.004"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.WCB.0000111614.19196.04"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1996.84.1.0097"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.49.1.113"},{"key":"e_1_3_6_7_2","first-page":"637","article-title":"Evolution of apparent diffusion coefficient, diffusion-weighted, and T2-weighted signal intensity of acute stroke","volume":"22","author":"Lansberg M.G.","year":"2001","unstructured":"Lansberg M.G., , Thijs V.N., , O'Brien M.W., , Ali J.O., , de Crespigny A.J., , Tong D.C., , Moseley M.E., , and Albers G.W. 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