The correlation of lesion progression to the diffusion mr findings and serum S100b levels in patients with traumatic intracerebral hemorrhage

The progression of traumatic intraparenchymal hemorrhages is the most common cause of clinical deterioration and death in patients with this hemorrhage. The successful treatment in these patients depends on identification of patients in the risk groups, detection of neurological deterioration before the beginning of progression and regulation of the treatment according to this.Diffusion MRI that produces images in minutes and does not require the use of contrast agent is a imaging method for increasingly used in head-injured patients.After brain injury, S100B protein in patients with head trauma is firstly released to CSF, and then into the bloodstream. A positive correlation was found between S100B levels and the severity of head injury, neurological table and prognosis.Our aim is to investigate the corelation of diffusion MR findings and serum S100B levels with the lesion progression.In our study, 30 trauma patients with detected intracerebral hemorrhage were evaluated. Patients? brain diffusion MRI was taken in the first 6 hours after trauma. Brain CT was taken at admission (1st hour), 24th hour, 48th hour and plasma S100B levels were measured at these hours. Patients with the progression and the progression-free patients were compared.The ischemic area surronding the lesion in patients with traumatic intracerebral hemorrhages showing progression were found proportionally larger than patients showing no progression. It was seen that progression risk was highly increased in especially the cases with ischemia/hemorrhage ratio above 2 in diffusion MRI. There was no statistically significant difference in favor of the group showing progression among S100B levels of patients with intacerebral hemorrhage showing progression and no pregression at 1st, 24th and 48th hours.As result, we think that ischemia/hemorrhage ratio in diffusion MRI is an important assistant parameter in the determination of progression risk.