Chapter 1 - Traumatic brain injury and in-hospital mortality- CT perfusion and beyond

Abstract

Traumatic brain injury is a major catastrophic event occurring primarily in young and healthy population who previously had excellent quality of life. It is estimated that more than 1.7 million cases of TBI occurs in the United States every year and approximately 5.4 billion people live with disabilities because of TBI in the United States alone. TBI can be detected using various imaging techniques such as plain head CT, CT angiogram, and CT perfusion and MRI. Plain head CT and CT angiogram has its own disadvantages, as they do not provide any functional aspects of the brain. This chapter mainly focuses on the advanced imaging technique called CT perfusion. CT perfusion provides both anatomical and functional aspects of the brain, and it is very useful in detection of TBI and brain death. In this chapter, we provide latest evidences on using CT perfusion at hospital admission and its relationship with in-hospital mortality rate. CT perfusion has immense potential and demonstrates superior efficacy when compared to other CT imaging techniques. It can be a reliable and prompt triage tool to diagnose brain death in patients with severe TBI. This will help reduce resource intensive but futile care in those who are already dead at the time of hospital admission and may facilitate the precious gift of organ donation.