Meningeal enhancement following traumatic brain injury: a mini review

Traumatic brain injury (TBI) is a significant cause of neurological morbidity, often leading to blood–brain barrier (BBB) dysfunction and secondary injury mechanisms. Recent advancements in neuroimaging have highlighted traumatic meningeal enhancement (TME) on contrast-enhanced fluid-attenuated inve...

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Main Authors: Alejandro Arbona-Lampaya, Alejandro Odeh-Couvertier, Ricardo Sánchez Jiménez, Eduardo Labat Álvarez
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Neurology
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Online Access:https://www.frontiersin.org/articles/10.3389/fneur.2025.1617126/full
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author Alejandro Arbona-Lampaya
Alejandro Odeh-Couvertier
Ricardo Sánchez Jiménez
Eduardo Labat Álvarez
author_facet Alejandro Arbona-Lampaya
Alejandro Odeh-Couvertier
Ricardo Sánchez Jiménez
Eduardo Labat Álvarez
author_sort Alejandro Arbona-Lampaya
collection DOAJ
description Traumatic brain injury (TBI) is a significant cause of neurological morbidity, often leading to blood–brain barrier (BBB) dysfunction and secondary injury mechanisms. Recent advancements in neuroimaging have highlighted traumatic meningeal enhancement (TME) on contrast-enhanced fluid-attenuated inversion recovery (FLAIR) MRI as a promising biomarker for detecting BBB disruption following TBI. TME, which is hypothesized to arise from vascular injury and inflammatory cascades that compromise the blood-meningeal barrier, has been associated with both acute trauma and long-term neurovascular dysfunction. Its presence, particularly when linked to subdural hematomas and delayed contrast extravasation, not only reflects the immediate severity of the injury but may also indicate chronic neuroinflammatory processes and persistent cognitive deficits. In this review, we gather current evidence on the pathophysiology of TME including its associations with vascular permeability, subdural hematoma, and prolonged inflammatory responses. We explore its potential as a biomarker for injury severity and prognosis in TBI patients. Finally, we further discuss the critical need for standardized imaging protocols and longitudinal studies to determine the clinical implications of persistent TME.
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spelling doaj-art-2e121416446946c68c73dc8dc82364382025-08-20T03:36:42ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-07-011610.3389/fneur.2025.16171261617126Meningeal enhancement following traumatic brain injury: a mini reviewAlejandro Arbona-Lampaya0Alejandro Odeh-Couvertier1Ricardo Sánchez Jiménez2Eduardo Labat Álvarez3School of Medicine, University of Puerto Rico–Medical Sciences Campus, San Juan, Puerto RicoSchool of Medicine, University of Puerto Rico–Medical Sciences Campus, San Juan, Puerto RicoDepartment of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto RicoDepartment of Diagnostic Radiology, University of Puerto Rico School of Medicine, San Juan, Puerto RicoTraumatic brain injury (TBI) is a significant cause of neurological morbidity, often leading to blood–brain barrier (BBB) dysfunction and secondary injury mechanisms. Recent advancements in neuroimaging have highlighted traumatic meningeal enhancement (TME) on contrast-enhanced fluid-attenuated inversion recovery (FLAIR) MRI as a promising biomarker for detecting BBB disruption following TBI. TME, which is hypothesized to arise from vascular injury and inflammatory cascades that compromise the blood-meningeal barrier, has been associated with both acute trauma and long-term neurovascular dysfunction. Its presence, particularly when linked to subdural hematomas and delayed contrast extravasation, not only reflects the immediate severity of the injury but may also indicate chronic neuroinflammatory processes and persistent cognitive deficits. In this review, we gather current evidence on the pathophysiology of TME including its associations with vascular permeability, subdural hematoma, and prolonged inflammatory responses. We explore its potential as a biomarker for injury severity and prognosis in TBI patients. Finally, we further discuss the critical need for standardized imaging protocols and longitudinal studies to determine the clinical implications of persistent TME.https://www.frontiersin.org/articles/10.3389/fneur.2025.1617126/fulltraumatic meningeal enhancementtraumatic brain injurysubdural hematomablood–brain barrier disruptionimaging biomarkers
spellingShingle Alejandro Arbona-Lampaya
Alejandro Odeh-Couvertier
Ricardo Sánchez Jiménez
Eduardo Labat Álvarez
Meningeal enhancement following traumatic brain injury: a mini review
Frontiers in Neurology
traumatic meningeal enhancement
traumatic brain injury
subdural hematoma
blood–brain barrier disruption
imaging biomarkers
title Meningeal enhancement following traumatic brain injury: a mini review
title_full Meningeal enhancement following traumatic brain injury: a mini review
title_fullStr Meningeal enhancement following traumatic brain injury: a mini review
title_full_unstemmed Meningeal enhancement following traumatic brain injury: a mini review
title_short Meningeal enhancement following traumatic brain injury: a mini review
title_sort meningeal enhancement following traumatic brain injury a mini review
topic traumatic meningeal enhancement
traumatic brain injury
subdural hematoma
blood–brain barrier disruption
imaging biomarkers
url https://www.frontiersin.org/articles/10.3389/fneur.2025.1617126/full
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AT ricardosanchezjimenez meningealenhancementfollowingtraumaticbraininjuryaminireview
AT eduardolabatalvarez meningealenhancementfollowingtraumaticbraininjuryaminireview