Acute phase of traumatic brain injury

Abstract

In neurotrauma, diagnostic imaging plays a fundamental role in the early detection of treatable injuries or the mitigation of secondary injuries. Currently, the routine imaging techniques used in the setting of a head trauma patient include non-contrast computed tomography (CT), computed tomography angiography (CTA), conventional magnetic resonance imaging (MRI) with T1, T2 or diffusion imaging. Of the above mentioned, CT is superior to MRI in terms of speed of examination, due to the greater access to portable equipment in the patient's environment, which reduces the risk of secondary complications at the time of transfer to the radiology department. Nevertheless, MRI provides a much higher quality of images than CT. MRI is not indicated for the diagnosis of acute brain injury, but if the results of CT without contrast are normal, and neurological manifestations are present, it is indicated. As a result, CT should be the first study requested to the imaging service by the medical team in charge of the patient during the acute phase of the traumatic brain injury. The main objective of this review is to present some of the advantages and disadvantages offered by the different diagnostic imaging methods when approaching and managing brain-injured patients, with emphasis on the acute phase of trauma.