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Advances in the Diagnosis of Head Injuries

Traumatic brain injuries have come to the forefront in our nation as of late and often attributed to blows to the head during sports, such as football, from Peewee football on up to the National Football League. Traumatic brain injuries are also caused by motor vehicle accident injuries, with the Centers for Disease Control and Prevention (CDC) stating these crashes rank third in the causes of traumatic brain injuries, representing 14% of those not ending in death, considering all age groups across the board. Since it can take days or even weeks for symptoms of a traumatic brain injury to become noticeable, and an injury best diagnosed immediately after occurrence, many accident victims are not conclusively diagnosed and treated properly.

When medical providers have enough suspicion of traumatic brain injury to warrant a diagnostic work-up, the first things often ordered are a brain computed tomography scan (CT) or perhaps a brain magnetic resonance imaging (MRI). These studies can be great at diagnosing structural issues within the brain but do not provide clues to the dynamic issues occurring within the brain or lesions. Another diagnostic method, single-photon emission tomography (SPECT), is used by some medical providers. This imaging is purported to be superior to traditional MRI and CT scans, as it can show bigger cognitive functional issues not shown on the other structurally oriented basic studies. With this method it is important to do the study within 4 weeks of injury.

However, an exciting diagnostic tool is now being lauded by many at the forefront of diagnosing and treating traumatic brain injuries. It is a much more advanced form of MRI called diffusion tensor imaging (DTI). This technology basically shows doctors the brain connections in the white matter that have suffered injury to allow them to better diagnose a patient with a dangerous, traumatic brain injury. Not every patient who has suffered head injury shows definitive cognitive functional deficits. Many such patients mention problems with dizziness, vision issues, and headaches long before experiencing cognitive deficits. Often times these patients think they are just suffering temporary injury that will go away with no permanent harm. Many medical providers think the same thing, but any head injury causing dizziness should be suspect for dangerous, traumatic injury to the brain and taken seriously. DTI can show the injury to the brain, even in more mild traumatic brain injuries and may help doctors understand the injury and individual prognosis better. DTI is currently available, but researchers continue to advance it and are hopeful that soon doctors can use DTI, not only to diagnose traumatic brain injuries, but to predict what injured part of the brain is connected to what particular symptom being experienced. Such strides can only serve the individual patient better and better in terms of diagnosis and treatment options.

The bottom line is to take any head injury seriously and go with technologically advanced diagnostics to be on the safe side, rather than the sorry one. If you have experienced an accident with head involvement, whether that be with a blunt contact injury or more of a shaken brain or whiplash injury, express your concerns directly to your medical provider and ask about whether DTI is available in your area as a means of better diagnosis.

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