Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-5cf477f64f-r2nwp Total loading time: 0 Render date: 2025-04-06T19:54:53.671Z Has data issue: false hasContentIssue false

Chapter 5 - Neuroimaging in Trauma

Published online by Cambridge University Press:  28 April 2020

By
Won Hyung A. Ryu ,
Jonathan Coles  and
Clare N. Gallagher
Edited by
Peter C. Whitfield ,
Jessie Welbourne ,
Elfyn Thomas ,
Fiona Summers ,
Maggie Whyte  and
Peter J. Hutchinson
Peter C. Whitfield
Affiliation:
Derriford Hospital, Plymouth
Jessie Welbourne
Affiliation:
University Hospitals, Plymouth
Elfyn Thomas
Affiliation:
Derriford Hospital, Plymouth
Fiona Summers
Affiliation:
Aberdeen Royal Infirmary
Maggie Whyte
Affiliation:
Aberdeen Royal Infirmary
Peter J. Hutchinson
Affiliation:
Addenbrooke’s Hospital, Cambridge
Get access

Summary

Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality with an estimated annual incidence of 295 per 100 000.1 Injury severity is broad and can range from mild, difficult to detect cognitive effects to profound disturbances of consciousness with prolonged coma and persistent vegetative state. The optimal modality and utility of neuroimaging depends not only on the mechanism and severity of injury but also the time since injury occurred and the information that is being sought out. The purpose of imaging patients with TBI includes guiding immediate treatment decisions, and prognostication of health outcome in the acute setting along with research into head injury pathophysiology. Indeed, recent advances in imaging techniques have allowed greater understanding of both structural and functional changes that occur after TBI. This review will briefly outline the techniques available for TBI and their usefulness in both clinical and research settings.

Type
Chapter
Information
Traumatic Brain Injury
A Multidisciplinary Approach
 , pp. 43 - 56
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Nguyen, R, et al. The international incidence of traumatic brain injury: a systematic review and meta-analysis. Can J Neurol Sci 2016;43(6):774–85.Google Scholar
Centers for Disease Control and Prevention. Report to Congress on traumatic brain injury in the United States: epidemiology and rehabilitation. Atlanta: Centers for Disease Control and Prevention; 2015.Google Scholar
Jagoda, AS, et al. Clinical policy: neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting. Ann Emerg Med 2008;52(6):714–48.Google Scholar
Toyama, Y, et al. CT for acute stage of closed head injury. Radiat Med 2005;23(5):309–16.Google Scholar
Teasdale, E, Hadley, DM. Imaging the head injury. 2nd edn. London: Hodder Educational; 2005.Google Scholar
Stiell, IG, et al. Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury. JAMA 2005;294(12):1511–18.Google Scholar
Smits, M, et al. External validation of the Canadian CT Head Rule and the New Orleans Criteria for CT scanning in patients with minor head injury. JAMA 2005;294(12):1519–25.Google Scholar
Sultan, HY, et al. Application of the Canadian CT head rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines. Emerg Med J 2004;21(4):420–5.Google Scholar
Hassan, Z, et al. Head injuries: a study evaluating the impact of the NICE head injury guidelines. Emerg Med J 2005;22(12):845–9.Google Scholar
Stiell, IG, et al. Canadian CT head rule study for patients with minor head injury: methodology for phase II (validation and economic analysis). Ann Emerg Med 2001;38(3):317–22.Google ScholarPubMed
Marincowitz, C, et al. The risk of deterioration in GCS13-15 patients with traumatic brain injury identified by computed tomography imaging: a systematic review and meta-analysis. J Neurotrauma 2018;35(5):703–18.Google Scholar
Lee, B, Newberg, A. Neuroimaging in traumatic brain imaging. NeuroRx 2005;2(2):372–83.Google Scholar
Bigler, ED, et al. Day-of-injury computerized tomography, rehabilitation status, and development of cerebral atrophy in persons with traumatic brain injury. Am J Phys Med Rehabil 2006;85(10):793–806.Google Scholar
Bradley, WG Jr. MR appearance of hemorrhage in the brain. Radiology 1993;189(1):15–26.CrossRefGoogle ScholarPubMed
Meythaler, JM, et al. Current concepts: diffuse axonal injury-associated traumatic brain injury. Arch Phys Med Rehabil 2001;82(10):1461–71.Google Scholar
Giugni, E, et al. Fast detection of diffuse axonal damage in severe traumatic brain injury: comparison of gradient-recalled echo and turbo proton echo-planar spectroscopic imaging MRI sequences. AJNR Am J Neuroradiol 2005;26(5):1140–8.Google ScholarPubMed
Sehgal, V, et al. Clinical applications of neuroimaging with susceptibility-weighted imaging. J Magn Reson Imaging 2005;22(4):439–50.CrossRefGoogle ScholarPubMed
Ashwal, S, Holshouser, BA, Tong, KA. Use of advanced neuroimaging techniques in the evaluation of pediatric traumatic brain injury. Dev Neurosci 2006;28(4–5):309–26.Google Scholar
Ashwal, S, et al. Susceptibility-weighted imaging and proton magnetic resonance spectroscopy in assessment of outcome after pediatric traumatic brain injury. Arch Phys Med Rehabil 2006;87(12 Suppl 2):S50–8.CrossRefGoogle ScholarPubMed
Mannion, RJ, et al. Mechanism-based MRI classification of traumatic brainstem injury and its relationship to outcome. J Neurotrauma 2007;24(1):128–35.Google Scholar
Smitherman, E, et al. Predicting outcome after pediatric traumatic brain injury by early magnetic resonance imaging lesion location and volume. J Neurotrauma 2016;33(1):35–48.Google Scholar
Abu Hamdeh, S, et al. Extended anatomical grading in diffuse axonal injury using mri: hemorrhagic lesions in the substantia nigra and mesencephalic tegmentum indicate poor long-term outcome. J Neurotrauma 2017;34(2):341–52.CrossRefGoogle ScholarPubMed
Huisman, TA. Diffusion-weighted imaging: basic concepts and application in cerebral stroke and head trauma. Eur Radiol 2003;13(10):2283–97.Google Scholar
Huisman, TA, et al. Diffusion-weighted imaging for the evaluation of diffuse axonal injury in closed head injury. J Comput Assist Tomogr 2003;27(1):5–11.Google Scholar
Kinoshita, T, et al. Conspicuity of diffuse axonal injury lesions on diffusion-weighted MR imaging. Eur J Radiol 2005;56(1):5–11.Google Scholar
Ezaki, Y, et al. Role of diffusion-weighted magnetic resonance imaging in diffuse axonal injury. Acta Radiol 2006;47(7):733–40.CrossRefGoogle ScholarPubMed
Schaefer, PW, et al. Diffusion-weighted MR imaging in closed head injury: high correlation with initial Glasgow Coma Scale score and score on modified Rankin Scale at discharge. Radiology 2004;233(1):58–66.Google Scholar
Bradley, PG, Menon, DK. Diffusion, perfusion weighted MR imaging in head injury. 1st edn. Cambridge: Cambridge University Press; 2005.Google Scholar
Moen, KG, et al. Traumatic axonal injury: the prognostic value of lesion load in corpus callosum, brain stem, and thalamus in different magnetic resonance imaging sequences. J Neurotrauma 2014;31(17):1486–96.Google ScholarPubMed
Chan, JH, et al. Diffuse axonal injury: detection of changes in anisotropy of water diffusion by diffusion-weighted imaging. Neuroradiology 2003;45(1):34–8.Google Scholar
Lee, JW, Choi, CG, Chun, MH. Usefulness of diffusion tensor imaging for evaluation of motor function in patients with traumatic brain injury: three case studies. J Head Trauma Rehabil 2006;21(3):272–8.Google Scholar
Mayer, AR, et al. A prospective diffusion tensor imaging study in mild traumatic brain injury. Neurology 2010;74(8):643–50.Google Scholar
Kraus, MF, et al. White matter integrity and cognition in chronic traumatic brain injury: a diffusion tensor imaging study. Brain 2007;130(Pt 10):2508–19.Google Scholar
Ling, JM, et al. Biomarkers of increased diffusion anisotropy in semi-acute mild traumatic brain injury: a longitudinal perspective. Brain 2012;135(Pt 4):1281–92.Google Scholar
Hulkower, MB, et al. A decade of DTI in traumatic brain injury: 10 years and 100 articles later. AJNR Am J Neuroradiol 2013;34(11):2064–74.Google Scholar
Betz, J, et al. Prognostic value of diffusion tensor imaging parameters in severe traumatic brain injury. J Neurotrauma 2012;29(7):1292–305.Google Scholar
Inglese, M, et al. Diffuse axonal injury in mild traumatic brain injury: a diffusion tensor imaging study. J Neurosurg 2005;103(2):298–303.Google Scholar
Salmond, CH, et al. Diffusion tensor imaging in chronic head injury survivors: correlations with learning and memory indices. Neuroimage 2006;29(1):117–24.Google Scholar
Wilde, EA, et al. Diffusion tensor imaging in the corpus callosum in children after moderate to severe traumatic brain injury. J Neurotrauma 2006;23(10):1412–26.CrossRefGoogle ScholarPubMed
Ewing-Cobbs, L, et al. Corpus callosum diffusion anisotropy correlates with neuropsychological outcomes in twins disconcordant for traumatic brain injury. AJNR Am J Neuroradiol 2006;27(4):879–81.Google Scholar
Veeramuthu, V, et al. Diffusion tensor imaging parameters in mild traumatic brain injury and its correlation with early neuropsychological impairment: a longitudinal study. J Neurotrauma 2015;32(19):1497–509.Google Scholar
Nakayama, N, et al. Evidence for white matter disruption in traumatic brain injury without macroscopic lesions. J Neurol Neurosurg Psychiatry 2006;77(7):850–5.Google Scholar
Huisman, TA, et al. Diffusion tensor imaging as potential biomarker of white matter injury in diffuse axonal injury. AJNR Am J Neuroradiol 2004;25(3):370–6.Google ScholarPubMed
Voss, HU, et al. Possible axonal regrowth in late recovery from the minimally conscious state. J Clin Invest 2006;116(7):2005–11.CrossRefGoogle ScholarPubMed
Yuh, EL, et al. Diffusion tensor imaging for outcome prediction in mild traumatic brain injury: a TRACK-TBI study. J Neurotrauma 2014;31(17):1457–77.Google Scholar
Logothetis, NK, et al. Neurophysiological investigation of the basis of the fMRI signal. Nature 2001;412(6843):150–7.CrossRefGoogle ScholarPubMed
Eierud, C, et al. Neuroimaging after mild traumatic brain injury: review and meta-analysis. Neuroimage Clin 2014;4:283–94.Google Scholar
Irimia, A, Van Horn, JD. Functional neuroimaging of traumatic brain injury: advances and clinical utility. Neuropsychiatr Dis Treat 2015;11:2355–65.Google ScholarPubMed
Lang, S, Duncan, N, Northoff, G. Resting-state functional magnetic resonance imaging: review of neurosurgical applications. Neurosurgery 2014;74(5):453–64; discussion 464–5.CrossRefGoogle ScholarPubMed
Hannawi, Y, et al. Resting brain activity in disorders of consciousness: a systematic review and meta-analysis. Neurology 2015;84(12):1272–80.Google Scholar
Sharp, DJ, et al. Default mode network functional and structural connectivity after traumatic brain injury. Brain 2011;134(Pt 8):2233–47.Google Scholar
Bonnelle, V, et al. Default mode network connectivity predicts sustained attention deficits after traumatic brain injury. J Neurosci 2011;31(38):13442–51.Google Scholar
Palacios, EM, et al. Resting-state functional magnetic resonance imaging activity and connectivity and cognitive outcome in traumatic brain injury. JAMA Neurol 2013;70(7):845–51.Google Scholar
Baron, JC, et al. Use of PET methods for measurement of cerebral energy metabolism and hemodynamics in cerebrovascular disease. J Cereb Blood Flow Metab 1989;9(6):723–42.CrossRefGoogle ScholarPubMed
Coles, JP. Imaging after brain injury. Br J Anaesth 2007;99(1):49–60.CrossRefGoogle ScholarPubMed
Coles, JP, et al. Incidence and mechanisms of cerebral ischemia in early clinical head injury. J Cereb Blood Flow Metab 2004;24(2):202–11.Google Scholar
Menon, DK, et al. Diffusion limited oxygen delivery following head injury. Crit Care Med 2004;32(6):1384–90.Google Scholar
Stein, SC, et al. Association between intravascular microthrombosis and cerebral ischemia in traumatic brain injury. Neurosurgery 2004;54(3):687–91; discussion 691.Google Scholar
Pickard, JD, et al. Imaging of cerebral blood flow and metabolism in brain injury in the ICU. Acta Neurochir Suppl 2005;95:459–64.Google Scholar
Cunningham, AS, et al. Physiological thresholds for irreversible tissue damage in contusional regions following traumatic brain injury. Brain 2005;128(Pt 8):1931–42.Google Scholar
Wu, HM, et al. Selective metabolic reduction in gray matter acutely following human traumatic brain injury. J Neurotrauma 2004;21(2):149–61.CrossRefGoogle ScholarPubMed
Vespa, P, et al. Metabolic crisis without brain ischemia is common after traumatic brain injury: a combined microdialysis and positron emission tomography study. J Cereb Blood Flow Metab 2005;25(6):763–74.CrossRefGoogle ScholarPubMed
Menon, DK. Brain ischaemia after traumatic brain injury: lessons from 15O2 positron emission tomography. Curr Opin Crit Care 2006;12(2):85–9.Google Scholar
Shin, SS, et al. Structural imaging of mild traumatic brain injury may not be enough: overview of functional and metabolic imaging of mild traumatic brain injury. Brain Imaging Behav 2017;11(2):591–610.Google Scholar
Folkersma, H, et al. Widespread and prolonged increase in (R)-(11)C-PK11195 binding after traumatic brain injury. J Nucl Med 2011;52(8):1235–9.Google Scholar
Ramlackhansingh, AF, et al. Inflammation after trauma: microglial activation and traumatic brain injury. Ann Neurol 2011;70(3):374–83.Google Scholar
Raji, CA, Henderson, TA. PET and Single-Photon Emission Computed Tomography in Brain Concussion. Neuroimaging Clin N Am 2018;28(1):67–82.Google Scholar
Gowda, NK, et al. Technetium Tc-99 m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study. AJNR Am J Neuroradiol 2006;27(2):447–51.Google Scholar
Shin, YB, et al. Voxel-based statistical analysis of cerebral blood flow using Tc-99 m ECD brain SPECT in patients with traumatic brain injury: group and individual analyses. Brain Inj 2006;20(6):661–7.CrossRefGoogle Scholar
Romero, K, et al. Old wine in new bottles: validating the clinical utility of SPECT in predicting cognitive performance in mild traumatic brain injury. Psychiatry Res 2015;231(1):15–24.Google Scholar
Uruma, G, Hashimoto, K, Abo, M. A new method for evaluation of mild traumatic brain injury with neuropsychological impairment using statistical imaging analysis for Tc-ECD SPECT. Ann Nucl Med 2013;27(3):187–202.CrossRefGoogle ScholarPubMed
Poon, WS, et al. Cerebral blood flow (CBF)-directed management of ventilated head-injured patients. Acta Neurochir Suppl 2005;95:9–11.Google Scholar
Inoue, Y, et al. Changes in cerebral blood flow from the acute to the chronic phase of severe head injury. J Neurotrauma 2005;22(12):1411–18.CrossRefGoogle Scholar
Fridley, J, Robertson, C, Gopinath, S. Quantitative lobar cerebral blood flow for outcome prediction after traumatic brain injury. J Neurotrauma 2015;32(2):75–82.Google Scholar
Kaloostian, P, et al. Outcome prediction within twelve hours after severe traumatic brain injury by quantitative cerebral blood flow. J Neurotrauma 2012;29(5):727–34.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×