The role of brain magnetic resonance imaging in pediatric sports-related concussion
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The present study utilizes brain magnetic resonance imaging protocols in various forms to investigate it's utility in the management and understanding of concussion. In the first phase of this study, neuroimaging findings from an adolescent sport-related concussion (SRC) cohort are summarized. The current guidelines for neuroimaging use have never summarized findings from this particular group and thus it was important to rule out the presence of structural abnormalities following an SRC. In the second phase of the study, we administered an MRI CO2 brain stress test to patients with post-concussion syndrome (PCS) and a group of age matched controls. Using two MRI protocols, blood-oxygen level dependent (BOLD) and pseudo-continuous arterial spin labelling (pCASL), we were able to examine the cerebrovascular responsiveness (CVR) to the vasoactive CO2 stimulus. The CO2 stimulus was administered using model-based prospective end-tidal (MPET) CO2 targeting delivered from a computerized gas-blender. Significantly findings from the study indicate that PCS may be characterized by patient specific alterations in regional blood flow and CVR despite normal global mean resting cerebral blood flow. Further work with this technology may be able to provide insights into the physiology of PCS as well as acute SRC.