Proton magnetic resonance spectroscopy (~1H MRS) of traumatic midbrain injury a tearly stage

Objective: : To study the changes of proton magnetic reson a nce spectroscopy (~1H MRS) in cerebral metabolites after traumatic midbrain in jury and to determine whether the changes can predict the outcome of these patie nts. Methods: Nineteen patients with traumatic midbrain injury w ere examined with quantitative ~1H MRS soon after injury (20 d post injury ), and 10 volunteers were also examined. The Cho, Cr, NAA, Cho/Cr, Cr/NAA, Cho/N AA were all determined, and the relationship between outcome (Glassgow Outcome Scale ) and coma stage were analyzed. Quantitative neurochemical finding s were also analyzed. Results: Patients with brain injury showe d diminished choline(Cho),creatine(Cr),Cho/Cr and Cho/ NAA levels compared with normal control volunteers. N-acetyl aspartate (NAA),Cr/NAA and Cho/NAA le vel correlated with GOS ( P 0.05). Patients in coma over 30 d displayed low ered Cho,Cho/Cr and Cho/NAA compared with other patients. Conclusion: The changes of ~1H MRS in midbrain can reflect local tissue injury after head trauma. There is a strong correlation between NAA and outcome, reducing extent of Cho,C ho/Cr and Cho/NAA level accords with coma stage.