Axonal injury in Intracerebral Hemorrhage

2012 Pilot Project Read More


Principal Investigator: Terrance Kummer (WashU Neurology)
Co-Investigators: David Brody (formerly WashU Neurology), Gregory Zipfel (WashU Neurosurgery)


Brain injury is a leading cause of death and disability in the United States.  Sudden brain injury usually takes one of two forms: traumatic or vascular.  Traumatic brain injury occurs when the head receives a severe external impact, possibly from an improvised explosive device, a car windshield, or even a barreling linebacker.  Victims of such events may develop brain damage near the site of impact, such as brain contusions, as well as diffuse brain injuries resulting from ripple effects of the impact.  The axons that make up the brain’s wiring are especially susceptible to such ripple effects, and diffuse axon injury may be the most important consequence of brain trauma.

Vascular brain injury takes the form of vascular blockage, causing strokes, and the far more deadly vascular rupture, which causes brain hemorrhages.  Hemorrhagic brain injury frequently results in coma and long-term cognitive and emotional impairment, both of which are likely caused by diffuse brain damage.  Although an enlarging bleed causes obvious injury to nearby brain tissue, very little is known about how hemorrhages impact the brain diffusely.  New results from our group indicate that axon injury, so crucial in traumatic brain injury, also occurs during hemorrhagic brain injury.  Our research is aimed at exploring this connection through the use of advanced brain imaging techniques available both in the laboratory and in the clinical setting.  We hope to define a new class of brain injury—vascular traumatic brain injury—thereby connecting the large body of research into traumatic brain injury to a vascular disease process of particular relevance to our aging population.  We believe that this framework will lead to new diagnostic and prognostic tests for victims of brain trauma, and help generate new targeted therapies.

Grants and Awards

“Advanced diffusion biomarkers of brain injury in subarachnoid hemorrhage”
NIH K08 NS 094860 01 (PI, Kummer)
The key to improving outcomes after subarachnoid hemorrhage lies in improving our understanding of how it damages the brain. Unfortunately a great deal of apparent brain injury goes undetected with conventional imaging studies. Therefore, we seek to develop new imaging parameters linked to defined pathologies that can be used to diagnose and monitor brain injury after subarachnoid hemorrhage, tie these pathologies to the outcomes of greatest relevance to patients, and ultimately target them with novel treatments.

“An MRI fingerprint of synapse loss in AD”
BrightFocus Foundation (PI, Kummer)


Kummer, Terrance T., Sandra Magnoni, Christine L. MacDonald, Krikor Dikranian, Eric Milner, James Sorrell, Valeria Conte, Joey J. Benetatos, Gregory J. Zipfel, and David L. Brody. “Experimental Subarachnoid Haemorrhage Results in Multifocal Axonal Injury.” Brain 138, no. 9: 2608–18, (2015).

Fanizzi, Claudia, Andrew D. Sauerbeck, Mihika Gangolli, Gregory J. Zipfel, David L. Brody, and Terrance T. Kummer. “Minimal Long-Term Neurobehavioral Impairments after Endovascular Perforation Subarachnoid Hemorrhage in Mice.” Scientific Reports 7, no. 1 (August 8, 2017): 7569.

Updated January 2019

Hope Center Investigators

Terrance Kummer

David Brody

Gregory Zipfel


This pilot project is made possible by the Danforth Foundation Challenge.

Danforth Challenge