Mild Traumatic Brain Injuries

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Background

Mild traumatic brain injuries (mTBI) are difficult to properly diagnose. Clinical symptoms of mTBI may not be obvious at the initial presentation to the ED. Standard imaging protocols differ from institution to institution, and some institutions may not even have a standard protocol to address mTBI. In addition, imaging performed during initial presentation is often a poor indicator of long-term effects associated with mTBI. In some patients, subtle structural changes are not recognizable initially and only appear during subsequent periodic scanning. Using additional MR outputs to periodically study mTBI patients, we hope to gain a better understanding of the structural changes occurring both during the injury and months after. Concurrent neuropsychological testing will allow us to better assess the long-term cognitive impacts of mTBI, and how those impacts correlate to observed structural changes. Direct correlation between cognitive impairment and structural changes will allow for improved prediction of patient outcome. There is currently no consensus on the long-term structural and cognitive effects of mTBI in patients undergoing periodic scans and evaluations.

Our neuroradiology department has developed a standard MR protocol to study TBI that includes 3D T1-BRAVO, 3D FLAIR, 3D SWAN, Diffusion Tensor, and MR Spectroscopy. In conjunction with periodic neuropsychological testing, we believe this protocol will be useful to study mTBI patients.