MRI better than CT for predicting long-term effects of brain trauma

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MRI may be superior to CT at predicting long-term outcomes for patients with traumatic brain injuries, according to a study published this month in the journal Annals of Neurology.

Researchers led by Esther Yuh, M.D., Ph.D., of the University of California San Francisco, followed 135 patients who had been treated for mild traumatic brain injuries at three emergency departments--San Francisco General Hospital, the University of Pittsburgh Medical Center and the University Medical Center Brackenridge in Austin, Texas--over a two-year period. Each was initially scanned by CT and then scanned a week or two later by MRI.

The investigators found that of the 135 patients presenting with mild traumatic brain injury, 99 had no visible sign of injury on the CT scan. But, of those 99 who had a clean CT, 27 had spots on their MRI scans that showed signs of microscopic bleeding in their brains.

Some patients who have mild traumatic brain injuries go on to have long-term neurological problems. According to the researchers, the ability to discern these small brain lesions with MRI will help physicians better predict whether these patients will develop neurological issues associated with their brain injuries.

"This work raises questions of how we're currently managing patients via CT scan," senior study author Geoff Manley, chief of neurosurgery at SFGH, said in an announcement. "Having a normal CT scan doesn't, in fact, say you're normal."

According to the researchers, by determining which patients are at further risk of developing persistent neurological problems, physicians will be able to follow those patients more closely. It would also help them identify patients who would benefit from new therapeutics and make clinical trials of those drugs more effective.

To learn more:
- see the abstract in Annals of Neurology
- read the announcement

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