Neuro-Imaging

After head trauma, “computerized tomography (CT or CAT Scan), magnetic resonance imaging (MRI), electroencephalogram (EEG), or routine neurological evaluations may be normal.”

Source: Definition of Mild Traumatic Brain Injury Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. J Head Trauma Rehabil 1993:8(3):86-87

One of the most important life saving breakthroughs in trauma medicine has been the development of CT and MRI scanning which have enabled us to see the enemy before it kills. The enemy in these cases is the often reversible focal conditions of hemorrhage, hematoma and edema.

Yet, as valuable as these diagnostic tools have been in guiding intervention in acute management of the severely injured brain, normal scans do not rule out even life threatening brain trauma. Thus, their diagnostic value in subtle brain injury, which typically involves diffuse damage, is limited. Subtle brain injury can only be identified by a triangulated evaluation of these three things:

• the patient’s acute history;
• the patient’s long term symptomatology; and
• a detailed neuropsychological assessment.

Thus, when considering the relevancy of scanning in the diagnosis of brain injury, it is important to understand what each of the below diagnostic tests can tell us about brain damage:

• CT – Computerized Tomography
• MRI – Magnetic Resonance Imaging
• EEG – Electroencephalography
• PET – Positron Emission Tomography
• SPECT – Single Photon/Positron Emission Computed Tomography
• ENG – Electronystagmography
• Vestibular Testing for Benign Positional Vertigo

Breakthrough:

The most modern MRI techniques are now showing significant pathologies in Subtle Brain Injury cases.

NEXT: MRI Breakthrough.

Understanding Subtle Brain Injury

The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.

View Our Video Series on Concussions