ABSTRACT
With significant advances in the field of neuroradiology in the last decade, the role
of neuroimaging in the evaluation of traumatic brain injury (TBI) continues to evolve.
In acute TBI, the neurosurgeon uses imaging primarily for the structural evaluation
of intracranial injuries, to assess for possible surgical intervention. Computed tomography
(CT) remains the modality of choice in this setting. Magnetic resonance (MR) imaging
is clearly superior for demonstrating nonsurgical lesions such as diffuse axonal injury,
small extra-axial collections, and brainstem pathology. Technical factors, in particular
time and patient monitoring, limit the utility of MR in the acute setting. It is therefore
generally reserved for patients whose neurological status is worse than predicted
from the CT findings or for targeted evaluation of the posterior fossa. More recently,
MR spectroscopy, MR diffusion, and functional imaging techniques such as positron
emission tomography (PET), single photon emission computed tomography (SPECT) and
functional MR imaging have yielded potential insights into the pathophysiology of
TBI. These modalities are likely to have a prognostic role in the management of trauma
patients.
KEYWORDS
CT - functional imaging - neuroimaging - mr imaging - traumatic brain injury
