Is radiology imaging needed to diagnose a TBI?

Imaging of the brain by computed tomography (CT) or magnetic resonance imaging (MRI) is not required to diagnose a traumatic brain injury. Instead, a TBI, especially on the milder end, is often diagnosed without imaging based on other factors that include loss of consciousness, alteration of consciousness or mental state, post-traumatic amnesia, or Glasgow Coma Scale score. Imaging can be negative or considered normal for mild, moderate, or even severe TBIs, but would be atypical for a severe TBI to be normal.

A CT scan if performed, is usually done during the acute phase (approximately 1 – 7 days) after a head injury because it’s cost effective, quick, and good at detecting life-threatening bleeds and skull fractures. A CT uses x-rays and takes about 10 minutes. A CT may not be performed when a concussion or mild TBI is suspected because the likelihood of a positive finding in those situations is usually outweighed by the risk of radiation exposure, cost, and busy ERs need the CT machine for other more seriously injured patients.

MRIs are more sensitive at measuring subtle or finer brain tissue damage such as microbleeds, diffuse axonal injury and metabolic changes that CTs cannot detect. MRIs take longer to perform than a CT and are generally more expensive. MRI does not use radiation, and there are numerous types of MRIs with varying sensitivity levels and advanced techniques designed to look at different structural components and functions of the brain. MRIs are generally performed after the acute phase and when symptoms persist.

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If you found this post helpful, you might also like to explore the other topics listed below and the many other topics in our comprehensive Safety & Prevention Guide, Brain Injury Guide, and Bike Injury Guide.