Neuroimaging in MTBI

Abstract

Abstract Perhaps the most elusive exercise in the science of MTBI has been the con- tinual pursuit of ‘‘objective’’ findings to demonstrate either underlying structural or functional abnormalities as markers of traumatic injury. The emergency management of MTBI typically centers on the decision to perform a head CT scan because of its utility in detecting hemorrhagic lesions and other structural injury that may require neurosurgical intervention or more acute triage. Therein lies the dilemma: while CT scans have great value in detecting neurosurgical emergencies, they also have the poorest sensitivity in detecting underlying abnormalities associated with milder forms of brain injury, including MTBI. The absence of focal findings on a CT scan is often incorrectly and inappropriately equated with a complete lack or nonexistence of brain injury, which then creates confusion among health care providers that often follows patients throughout their clinical management after injury. There is a continual pursuit in the neurosciences to develop imaging tech- niques sensitive to detecting structural and functional abnormalities following milder forms of brain injury, even in the absence of traumatic abnormalities on head CT scan.

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