Abstract

In the present era, trauma is the commonest cause of death in the middle aged group. Cranio Cerebral Trauma (CCT) is common in both urban and rural areas and is associated with high morbidity and mortality rates. In any case of trauma, the outcome depends on two major issues: detection of type and extent of injury and the time taken for management. Though, the presenting neurologic status of the patient is the single best predictor of clinical outcome, but imaging determines the prognosis of these patients especially when the Glasgow coma scale (GCS) is high. There have been major advancements in the field of neuroimaging for CCT over the last decade.

Highlights

  • In the present era, trauma is the commonest cause of death in the middle aged group [1]

  • The presenting neurologic status of the patient is the single best predictor of clinical outcome, but imaging determines the prognosis of these patients especially when the Glasgow coma scale (GCS) is high

  • Later stages are characterized by progressive loss of gray white matter differentiation; sometimes producing white or reverse cerebellar sign characterized by diffusely hypodense cerebral hemispheres with relatively hyperdense cerebellum (Figure 1)

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Summary

Introduction

Trauma is the commonest cause of death in the middle aged group [1]. Computed tomography (CT) especially non enhanced scan (NECT) plays a major role in the evaluation of CCT with magnetic resonance imaging (MRI) (including MR spectroscopy and functional imaging) serving primarily as a problem-solvng tool in cases with discordance between clinical state of patient image NECT scan; cases with high suspicion of diffuse axonal injury image in chronic cases with traumatic sequelae where NECT is equivocal or inconclusive. MRI has a better soft tissue resolution and is more sensitive in detecting parenchymal lesions of brain especially in the white matter and non-hemorrhagic lesions. It can detect early hemorrhage and can stage it. Major disadvantages of MRI include longer examination times, high susceptibility to motion, incompatibility with life support systems, limited accessibility and higher cost. It still remains a problem solving tool because of its limited availability and high cost

Indications of Imaging in Craniocerebral Trauma
Imaging Options in CCT
Conclusion
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