Traumatic Brain Injury: Radiological Findings and Clinical Outcome
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GERIATRICS (G GUGLIELMI, SECTION EDITOR)
Traumatic Brain Injury: Radiological Findings and Clinical Outcome Rosario Francesco Balzano1 • Teresa Popolizio2 • Roberto Izzo2 • Marco Perri3 Anna Maria Pennelli2 • Bilal Al-Badayneh4 • Giuseppe Guglielmi2,5,6
•
Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of the Review This review talks about the principal imaging investigations in traumatic brain injury (TBI). Physiopathological mechanisms are briefly discussed. The article will focus on the major brain lesions and their imaging appearance with also reference to the most recent techniques that can correlate with prognosis. Recent Findings Neuroimaging plays a principal role in the evaluation of TBI. CT and MRI are used for the evaluation of pathological findings after the trauma and for the follow-up. Several classification systems have been proposed to correlate neuroimaging findings and patients’ outcome. Novel functional imaging techniques, such as diffusion tensor imaging, may provide further important information for the prediction of prognosis.
This article is part of the Topical collection on Geriatrics. & Giuseppe Guglielmi [email protected] 1
Department of Radiology, ‘‘Dimiccoli’’ Hospital, Viale Ippocrate, 15, 70051 Barletta, Italy
2
Department of Radiology, Fondazione IRCCS ‘‘Casa Sollievo della Sofferenza’’, viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia, Italy
3
Department of Radiology, Ospedale SS Filippo e Nicola, ASL-1 Avezzano, via G. Di Vittorio, 67051 Sulmona, L’Aquila, Italy
4
Department of Radiology, The Hashemite University Faculty of Medicine, Zarqa, Jordan
5
Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71121 Foggia, Italy
6
University Campus of Barletta, ‘‘Dimiccoli’’ Hospital, Viale Ippocrate, 15, 70051 Barletta, Italy
Summary CT is the best imaging tool for the acute evaluation of patients with TBI. MRI has higher sensibility in the detection of brain lesions, but currently is mostly used in the follow-up. Functional imaging techniques are very promising, but still are not currently included in the clinical evaluation. Keywords TBI CT MRI DTI Outcome
Introduction Traumatic brain injury (TBI) is defined as a brain injury caused by transmission of physical external forces (directly or indirectly) to the head, which in turn cause an alteration in the brain tissue [1, 2]. It is one of the major causes of mortality worldwide and is also associated to long-term (even severe) sequelae in those who survive, eventually influencing their quality of life. Following TBI, patients can manifest different clinical signs and symptoms, as cognitive, behavioral and neurological deficits, according to the severity [3••]. Epidemiology Every year, brain trauma involves a number of 1.7 million people and the most of them are classified as mild traumatic brain trauma (mTBI) [4]. Mortality accounts for 17 per 100,000 hospitalizati
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