Classification of traumatic brain lesions according to MRI data: a new grading scale.

Advanced MRI was shown to be sensitive for detection of traumatic brain lesions. However, its prognostic value is a subject to investigate. Our aim was to study the relationship between the level and localization of brain lesions verified by advanced MRI sequences and traumatic brain injury (TBI) severity and outcome. MRI in conventional and advanced sequences was used to investigate 212 patients aged 8 - 74 (average 31 +/- 14) with acute TBI in 2001 - 2014. All patients were graded into eight categories according to downward distribution of lesions into deep brain structures (cortical-subcortical structures, corpus callosum, subcortical nuclei, thalami as well as uni-or bilateral midbrain, pons and medulla oblongata). We found a significant correlation between proposed MRI grading scale and both GCS (R=-0,64; p<0,0001) and GOS (R=-0,66; p<0,0001). Based on this study a new MRI grading scale of brain lesions level and localization is believed to have an improved prognostic value. Further investigation is needed to estimate its predictive significance.