Neuroimaging clinics of North America
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Traumatic intracranial hemorrhage is a leading cause of morbidity and mortality in the United States. CT remains the primary imaging modality for initial evaluation of patients who have sustained head trauma. MR imaging, which has always been important for the evaluation of subacute and chronic head trauma, has been gaining popularity and recognition as an alternative primary imaging modality.
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Though advances in MRI will undoubtedly increase its use, particularly in the subacute period, CT will likely continue its primary role in the management of these injuries in the foreseeable future. The spectrum of imaging features of cranial gunshot injuries is vast, because they encompass all of the findings encountered in closed head injury in addition to the wide variety of problems associated with penetration. Thus, only a brief summary of the many varied aspects of this complex problem is presented here as a review of the more salient issues.
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The consequences of cerebral herniation are compression of the brain, cranial nerves, and blood vessels that may result in serious neurologic morbidity, coma, and even death. A thorough understanding of the various patterns of cerebral herniation is essential, and it is important to remember that many of these patterns of herniation overlap. CT and MR imaging are effective at establishing the diagnosis of cerebral herniation, which will guide important decisions regarding therapeutic options and prognosis.
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This article discusses all types of traumatic head injury in infants, children and adolescents. Neuroimaging patterns of injury help to make the precise diagnosis and assists in monitoring responses to therapy.
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Head trauma is a very common and sometimes life-threatening medical condition that involves sports medicine physicians, emergency room physicians, neurologists, neurosurgeons, orthopedists, anesthesiologists, rehabilitation physicians, psychiatrists, and radiologists; as well as allied health care workers such as physical, occupational, and speech therapists, clinical psychologists, neuropsychologists, and many others. Head trauma needs to be approached by a mutlidisciplinary team because it is complex. ⋯ These advances have truly revolutionized medicine and it has happened rapidly--pneumoencephalography was the neuroimaging study of choice less than half a century ago. The future of neuroimaging in head trauma will undoubtedly include advances we can not yet foresee but that will allow clinicians to continue to improve patient care.