Traumatic Cerebral Microbleeds in the Subacute Phase Are Practical and Early Predictors of Abnormality of the Normal-Appearing White Matter in the Chronic Phase

A W van der Eerden*, T L van den Heuvel, V Perlbarg, P Vart, P E Vos, L Puybasset, D Galanaud, B Platel, R Manniesing, B M Goraj

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


BACKGROUND AND PURPOSE: In the chronic phase after traumatic brain injury, DTI findings reflect WM integrity. DTI interpretation in the subacute phase is less straightforward. Microbleed evaluation with SWI is straightforward in both phases. We evaluated whether the microbleed concentration in the subacute phase is associated with the integrity of normal-appearing WM in the chronic phase.

MATERIALS AND METHODS: Sixty of 211 consecutive patients 18 years of age or older admitted to our emergency department ≤24 hours after moderate to severe traumatic brain injury matched the selection criteria. Standardized 3T SWI, DTI, and T1WI were obtained 3 and 26 weeks after traumatic brain injury in 31 patients and 24 healthy volunteers. At baseline, microbleed concentrations were calculated. At follow-up, mean diffusivity (MD) was calculated in the normal-appearing WM in reference to the healthy volunteers (MDz). Through linear regression, we evaluated the relation between microbleed concentration and MDz in predefined structures.

RESULTS: In the cerebral hemispheres, MDz at follow-up was independently associated with the microbleed concentration at baseline (left: B = 38.4 [95% CI 7.5-69.3], P = .017; right: B = 26.3 [95% CI 5.7-47.0], P = .014). No such relation was demonstrated in the central brain. MDz in the corpus callosum was independently associated with the microbleed concentration in the structures connected by WM tracts running through the corpus callosum (B = 20.0 [95% CI 24.8-75.2], P < .000). MDz in the central brain was independently associated with the microbleed concentration in the cerebral hemispheres (B = 25.7 [95% CI 3.9-47.5], P = .023).

CONCLUSIONS: SWI-assessed microbleeds in the subacute phase are associated with DTI-based WM integrity in the chronic phase. These associations are found both within regions and between functionally connected regions.

Original languageEnglish
Pages (from-to)861-867
Number of pages7
JournalAmerican Journal of Neuroradiology
Issue number5
Publication statusPublished - May-2021
Externally publishedYes


  • Acute Disease
  • Adult
  • Brain Injuries, Traumatic/diagnostic imaging
  • Cerebral Hemorrhage/diagnostic imaging
  • Chronic Disease
  • Corpus Callosum/diagnostic imaging
  • Diffusion Magnetic Resonance Imaging
  • Diffusion Tensor Imaging
  • Emergency Medical Services
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • White Matter/diagnostic imaging

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