Examination of TBIRD cases in our hospital

Abstract

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized by biphasic seizures and a bright tree appearance (BTA) on diffusion-weighted imaging. Recent studies have also implicated trauma as an etiopathogenetic contributor to a similar condition that is referred to as infantile traumatic brain injury with a biphasic clinical course and late reduced diffusion (TBIRD). Several studies have reported that extensive BTA is associated with poor prognosis, and early diagnosis and prompt intervention are important. Objective: We retrospectively investigated characteristics of patients with TBIRD at our hospital. Method: The study included patients with subdural hematomas (56 lesions), who were hospitalized between April 2016 and December 2021. BTA-positive cases were identified from the control group and retrospectively investigated. Result: We observed 4 patients with TBIRD (all aged <1 year). All 4 patients had subdural hematomas along the falx. Glutamate-mediated cell excitotoxicity has attracted attention as a pathophysiological mechanism underlying TBIRD. Focusing on the mechanism underlying injury and subdural hematoma localization may be useful to predict TBIRD and improve treatment outcomes. Interfacility coordination and sharing of treatment experiences are important in future.