Mri Findings With Traumatic Brain Injuries
Traumatic brain injuries (TBI) is one of the major causes of disability, mortality and medical costs internationally, especially among population under the age of 44. The mean of hospitalized and fatal TBI in Europe is 235 per 100,000 and the double of that in the US 50,000 deaths occur annually in the US, and 1.4 million TBIs internationally. This cost about $60 billions annually. In KSA, in an 8 years retrospective study they found 1219 patient below 18 years old diagnosed with TBI. Mostly motor vehicle crash related head injuries are the leading cause in these injuries.
Currently there are several clinical guidelines available for diagnosis and management of mild TBI. Multiple pathological entities are consist of TBI and it is defined by an "alteration in brain function" otherwise an evidence of other brain pathology which caused by an external force. Imaging is playing an important role in assessing and diagnose TBI cases, especially its valuable role for triage in the acute setting to determine the patients whose require emergent neurosurgical intervention.
The imaging modality of choice for evaluation of the acute injuries of the head is Computed Tomography (CT). It is non-invasive, quick, and widely accessible and has few contraindications. CT pros are valuable in assessment of TBI include its sensitivity for demonstrating acute intra-axial and extra-axial hemorrhage, ventricular size, mass effect, and bone fractures. Limitations include low sensitivity in detecting small non-hemorrhagic lesions such as cortical contusions and diffuse axonal injuries (DAIs), as well as in early demonstration of hypoxic– ischemic encephalopathy. In contrast, Magnetic resonance imaging (MRI) is more sensitive than CT for detection of small post-traumatic focal brain lesions. It is seldom performed in the acute setting of TBI because of the complex logistics of patient transport and monitoring, long imaging times and sensitivity to patient.
MRI is considered the modality of choice for patients with subacute and chronic TBI and is recommended for patients with acute head trauma when CT fails to explain the neurological findings. Thus, the radiologist and treating practitioner should be familiar with the various imaging findings of TBI cases and their impact on clinical presentation, prognosis and management. In the current study, the primary goal is to determine the frequency of the brain CT-scan findings, MRI findings with TBI and patients whose required urgent neurosurgical intervention. Our secondary objective is to describe the demographical data and mechanism of brain injury of these cases.
