Search tips
Search criteria 


Logo of jnnpsycJournal of Neurology, Neurosurgery and PsychiatryVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
J Neurol Neurosurg Psychiatry. 1988 March; 51(3): 391–396.
PMCID: PMC1032866

Early and late magnetic resonance imaging and neuropsychological outcome after head injury.


Twenty five adults with closed head injury who had early magnetic resonance imaging (MRI) and computed tomography (CT) were followed up 5 to 18 months after injury. Patients were given a repeat MRI and performed a series of neuropsychological tests. They were classified by the deepest abnormality detectable on scanning. Classifications derived from early and late MRI scanning were significantly correlated. However, measures of neuropsychological outcome showed a strong correlation only with late MRI, and little or no relationship with either early MRI or early CT. Deeper abnormalities detected by late MRI were associated with poorer neuropsychological test performance; late ventricular enlargement was particularly associated with poor outcome. It is concluded that the lesions visualised by MRI are important for neuropsychological outcome, and that functionally significant abnormalities may only be fully apparent on late scanning.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Adams JH, Graham DI, Murray LS, Scott G. Diffuse axonal injury due to nonmissile head injury in humans: an analysis of 45 cases. Ann Neurol. 1982 Dec;12(6):557–563. [PubMed]
  • Jenkins A, Teasdale G, Hadley MD, Macpherson P, Rowan JO. Brain lesions detected by magnetic resonance imaging in mild and severe head injuries. Lancet. 1986 Aug 23;2(8504):445–446. [PubMed]
  • Snow RB, Zimmerman RD, Gandy SE, Deck MD. Comparison of magnetic resonance imaging and computed tomography in the evaluation of head injury. Neurosurgery. 1986 Jan;18(1):45–52. [PubMed]
  • Teasdale G, Parker L, Murray G, Knill-Jones R, Jennett B. Predicting the outcome of individual patients in the first week after severe head injury. Acta Neurochir Suppl (Wien) 1979;28(1):161–164. [PubMed]
  • DE RENZI E, VIGNOLO LA. The token test: A sensitive test to detect receptive disturbances in aphasics. Brain. 1962 Dec;85:665–678. [PubMed]
  • Nelson HE, O'Connell A. Dementia: the estimation of premorbid intelligence levels using the New Adult Reading Test. Cortex. 1978 Jun;14(2):234–244. [PubMed]
  • Nelson HE, McKenna P. The use of current reading ability in the assessment of dementia. Br J Soc Clin Psychol. 1975 Sep;14(3):259–267. [PubMed]
  • Mandleberg IA, Brooks DN. Cognitive recovery after severe head injury. 1. Serial testing on the Wechsler Adult Intelligence Scale. J Neurol Neurosurg Psychiatry. 1975 Nov;38(11):1121–1126. [PMC free article] [PubMed]
  • Cullum CM, Bigler ED. Ventricle size, cortical atrophy and the relationship with neuropsychological status in closed head injury: a quantitative analysis. J Clin Exp Neuropsychol. 1986 Aug;8(4):437–452. [PubMed]
  • Meyers CA, Levin HS, Eisenberg HM, Guinto FC. Early versus late lateral ventricular enlargement following closed head injury. J Neurol Neurosurg Psychiatry. 1983 Dec;46(12):1092–1097. [PMC free article] [PubMed]
  • Condon B, Patterson J, Wyper D, Hadley D, Grant R, Teasdale G, Rowan J. Use of magnetic resonance imaging to measure intracranial cerebrospinal fluid volume. Lancet. 1986 Jun 14;1(8494):1355–1357. [PubMed]
  • Ommaya AK, Gennarelli TA. Cerebral concussion and traumatic unconsciousness. Correlation of experimental and clinical observations of blunt head injuries. Brain. 1974 Dec;97(4):633–654. [PubMed]
  • Levin HS, Grossman RG, Rose JE, Teasdale G. Long-term neuropsychological outcome of closed head injury. J Neurosurg. 1979 Apr;50(4):412–422. [PubMed]
  • Sichez-Auclair N, Sichez JP. Profils neuropsychologiques et mentaux dans les lésions encéphaliques diffuses post-traumatiques sévères. 103 cas. Neurochirurgie. 1986;32(1):63–73. [PubMed]
  • van Dongen KJ, Braakman R. Late computed tomography in survivors of severe head injury. Neurosurgery. 1980 Jul;7(1):14–22. [PubMed]
  • Levin HS, Meyers CA, Grossman RG, Sarwar M. Ventricular enlargement after closed head injury. Arch Neurol. 1981 Oct;38(10):623–629. [PubMed]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Group