Interest of the 7 Tesla MRI in the Diagnosis of Post-concussion Syndromes Among Patients With Mild Traumatic Brain Injury

Among patients admitted in emergency care units in France for mild traumatic brain injury, 10 % will develop post concussionnal symptoms. The variability of the clinical presentation lead to a syndrome at the border of neurology, psychiatry and neuro-traumatology. Ninety per cent of these patients will have a favorable evolution in three to six months while ten per cent will have persistant symptoms : dizziness, headache, nausea, drowsiness, anxio-depressive symptoms, irritability, memory impairments, attentionnal disorders. This conduct to an additionnal medical and social cost (medical re-consultation in emergency services, pharmaceutical expenditure due to over medication, social recognition, deterioration of social and professionnal relationships …). The litterature data show the presence of diffuse axonal lesions (DAL) frequently observed in patients victims of MTBI. These lesions seemed to be correlate with the occurrence of post concussional symptoms. New brain imagery have lead to these discoveries but are not relevant in clinical routine (functionnal MRI, Diffusion Tensor Imaging, tractography). Computed Tomography is often normal and not able to detect these lesions. Standard MRI is not enough sensible for the detection of the DAL. Some autor shows alose that his sensibility decrease in time.

These observations and encouraging results lead us to initiate a prospective interventionnal, longitudinal, pilot study monocentric using seven tesla MRI to evaluate its input in the detection of diffuse axonal lesions among patients presenting post concussionnal symptoms after a mild traumatic brain injury at day seven after they are admitted to our emergency service.

• Evaluate the S100b dosed at admission is correlated with the occurrence of post concussion syndrome after a mild head injury. [Срок оценки: Day 0]
• Evaluate the S100b dosed at admission is correlated with diffuse axonal lesion [Срок оценки: Day 7, Month 6, Month 12]
• Assess the quality of life of patients suffering for post-cocussion syndrome [Срок оценки: Day 7, Month[6;12]]
• Correlation the association between the alteration of the anisotropy fraction (AF) and post-concussion syndrome on the MRI diffusion tensor (DTI) sequence [Срок оценки: Day 7]
• Describe the diagnostic performance of the 7 T MRI and quality of life on the occurrence of a post-concussion syndrome [Срок оценки: Month [3;6;12]]
• Compare the performance obtained on cognitive functioning as a function of cognitive reserve [Срок оценки: Month 3]
• Compare in patients the presence of anxio-depressive syndrome [Срок оценки: Month 3]
• Correlation the association between the presence of a lesion on 7T MRI and the results of various neuropsychological tests. [Срок оценки: Month 12]