{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T21:58:48Z","timestamp":1791669528692,"version":"4.3.4"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,10,14]],"date-time":"2019-10-14T00:00:00Z","timestamp":1571011200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100013130","name":"Center for Neuroscience and Regenerative Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013130","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Intramural Research Programs"},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"NINDS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001229","name":"Mathers Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001229","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Traumatic microbleeds are small foci of hypointensity seen on T2*-weighted MRI in patients following head trauma that have previously been considered a marker of axonal injury. The linear appearance and location of some traumatic microbleeds suggests a vascular origin. The aims of this study were to: (i) identify and characterize traumatic microbleeds in patients with acute traumatic brain injury; (ii) determine whether appearance of traumatic microbleeds predict clinical outcome; and (iii) describe the pathology underlying traumatic microbleeds in an index patient. Patients presenting to the emergency department following acute head trauma who received a head CT were enrolled within 48 h of injury and received a research MRI. Disability was defined using Glasgow Outcome Scale-Extended \u22646 at follow-up. All magnetic resonance images were interpreted prospectively and were used for subsequent analysis of traumatic microbleeds. Lesions on T2* MRI were stratified based on \u2018linear\u2019 streak-like or \u2018punctate\u2019 petechial-appearing traumatic microbleeds. The brain of an enrolled subject imaged acutely was procured following death for evaluation of traumatic microbleeds using MRI targeted pathology methods. Of the 439 patients enrolled over 78 months, 31% (134\/439) had evidence of punctate and\/or linear traumatic microbleeds on MRI. Severity of injury, mechanism of injury, and CT findings were associated with traumatic microbleeds on MRI. The presence of traumatic microbleeds was an independent predictor of disability (P &amp;lt; 0.05; odds ratio = 2.5). No differences were found between patients with punctate versus linear appearing microbleeds. Post-mortem imaging and histology revealed traumatic microbleed co-localization with iron-laden macrophages, predominately seen in perivascular space. Evidence of axonal injury was not observed in co-localized histopathological sections. Traumatic microbleeds were prevalent in the population studied and predictive of worse outcome. The source of traumatic microbleed signal on MRI appeared to be iron-laden macrophages in the perivascular space tracking a network of injured vessels. While axonal injury in association with traumatic microbleeds cannot be excluded, recognizing traumatic microbleeds as a form of traumatic vascular injury may aid in identifying patients who could benefit from new therapies targeting the injured vasculature and secondary injury to parenchyma.<\/jats:p>","DOI":"10.1093\/brain\/awz290","type":"journal-article","created":{"date-parts":[[2019,9,12]],"date-time":"2019-09-12T15:32:18Z","timestamp":1568302338000},"page":"3550-3564","source":"Crossref","is-referenced-by-count":134,"title":["Traumatic microbleeds suggest vascular injury and predict disability in traumatic brain injury"],"prefix":"10.1093","volume":"142","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7055-068X","authenticated-orcid":false,"given":"Allison D","family":"Griffin","sequence":"first","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Acute Cerebrovasular Diagnostics Unit of the National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L Christine","family":"Turtzo","sequence":"additional","affiliation":[{"name":"Acute Cerebrovasular Diagnostics Unit of the National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunjan Y","family":"Parikh","sequence":"additional","affiliation":[{"name":"R. Adams Cowley Shock Trauma Center, Program in Trauma, University of Maryland School of Medicine, Baltimore, USA"},{"name":"Division of Neurocritical Care and Emergency Neurology, Department of Neurology, University of Maryland School of Medicine, Baltimore, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Tolpygo","sequence":"additional","affiliation":[{"name":"Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Lodato","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Cold Spring Harbor Laboratory, Cold Spring Harbor, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita D","family":"Moses","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Acute Cerebrovasular Diagnostics Unit of the National Institute of Neurologic Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Govind","family":"Nair","sequence":"additional","affiliation":[{"name":"National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel P","family":"Perl","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy A","family":"Edwards","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch of the National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard J","family":"Dardzinski","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina C","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Center for Neuroscience and Regenerative Medicine, Bethesda, Maryland, USA"},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhik","family":"Ray-Chaudhury","sequence":"additional","affiliation":[{"name":"Surgical Neurology Branch of the National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partha P","family":"Mitra","sequence":"additional","affiliation":[{"name":"Cold Spring Harbor Laboratory, Cold Spring Harbor, New 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