Study Says MRIs Effectively Predict Brain-Injury Outcomes

Hospitals may see an increase in MRI equipment after a study published in the journal Annals of Neurology on Dec. 7 revealed that MRIs might be better at predicting long-term outcomes for people with mild traumatic brain injuries than CT scans.

The clinical trial, led by researchers at the University of California, San Francisco (UCSF) and the San Francisco General Hospital and Trauma Center (SFGH), followed 135 people treated for mild traumatic brain injuries over the past two years at one of three urban hospitals with level-one trauma centers. The three hospitals involved in the study, called National Institutes of Health-funded TRACK-TBI (Transforming Research and Clinical Knowledge in Traumatic Brain Injury), were SFGH, the University of Pittsburgh Medical Center and the University Medical Center Breckenridge in Austin, Texas.

The 135 patients received CT scans upon admittance to the hospital and were given MRIs about a week after. Ninety-nine of them had “normal” CT scans, but 27 of those 99 patients had detectable spots on their MRI scans showing signs of microscopic bleeding in the brain. These focal lesions helped the doctors predict whether the patients would suffer persistent neurological problems. As of now, 15 percent of patients with mild traumatic brain injuries suffer long-term neurological problems, but doctors don’t have a way to predict these outcomes.

“This work raises questions of how we’re currently managing patients via CT scan,” said senior author on the study Geoff Manley, MD, PhD, the chief of neurosurgery at SFGH and vice-chair of the Department of Neurological Surgery at UCSF in a statement. “Having a normal CT scan doesn’t, in fact, say you’re normal.”

More than 1.7 million Americans receive medical attention for head injuries every year, and 75 percent of them have mild traumatic brain injuries. However, only injuries bad enough to seek attention from an emergency room are included, according to the U.S. Centers for Disease Control and Prevention, which means many more mild traumatic brain injuries happen every year. Most patients that do show up are treated and released without being admitted to the hospital. While several of them have a full recovery, one in six develop chronic and occasionally permanent disability.

The article, “Magnetic Resonance Imaging Improves 3-Month Outcome Prediction in Mild Traumatic Brain Injury,” is a significant step in finding a quantitative approach to detecting, monitoring and treating mild traumatic brain injuries.

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