Do old brain lesions appear on MRI?

MRI can show brain atrophy long after the injury, which occurs when injured or dead brain tissue is resorbed after brain injury. Because injured brain tissue may not fully recover after a traumatic brain injury, doctors can detect TBI-related changes many years after an injury. However, diagnosing brain injuries can be complicated. About 80 percent of TBIs cannot be seen on an MRI or CT scan.

The only other way to discover a traumatic brain injury used to be neuropsychological or psychological testing, a fancy way of saying that doctors ask patients questions or give them tasks to complete. A CT scan takes pictures to create pictures of the brain. The scan can show if there is a fracture or bleeding. An MRI creates clear images of brain tissue.

But mild traumatic brain injuries don't show up on standard brain imaging tests because the tissue isn't obviously damaged. The postconcussion syndrome affects the ability of neurons (brain cells) to indicate the right amount of blood to carry out certain processes (among other things), but does not cause structural degradation to the cells themselves. Simple X-rays don't tell anyone much about the brain, and even a CT scan may look normal even if a brain injury has occurred. An electroencephalogram performed early may have shown the impact the collision had on your grandson's brain.

An MRI of your head with sequences of images of the diffusion tensor may show some evidence of an old injury. If your grandchild had any of the symptoms listed, talk to your pediatrician about the possibility that he or she had a traumatic brain injury as a baby. After the acute period after traumatic brain injury, neuroradiology is used to detect lesions, especially indications of microscopic injury to the axons (nerve fibers), which may explain the persistence or worsening of TBI-related symptoms. Magnetic resonance imaging (MRI) is a powerful diagnostic tool that can detect signs of injury such as tiny bleeding (microhemorrhage), small areas of bruising (contusion), or scarring (gliosis), which are invisible to computed tomography.

Newer and more specialized types of MRI can evaluate brain structure at an even finer level or measure brain function to detect alterations in brain structure and function due to traumatic brain injury. However, since the microscopic injury to the brain can be a cause of problems, even MRI may not be able to detect any abnormalities in a patient with TBI. Long after the injury, MRI and CT can show brain atrophy, which occurs when dead or injured brain tissue is resorbed after TBI. Because injured brain tissue may not fully recover after a traumatic brain injury, changes due to TBI can be detected for many years.

Early detection of brain injuries can lead to substantially shorter recoveries and better outcomes. Before you or your doctor notices a problem, an MRI can identify the brain injury within the critical first 48 hours after you have suffered it and start making a plan from there. The longer between maintaining and treating your brain injury, the more likely you are to suffer secondary injuries that result from the initial trauma. Traumatic brain injury (TBI) can be as debilitating as amputations, burns, and spinal cord injuries.

But as newer versions of the technology become available, doctors can better see minor injuries and concussions when using MRI. Many brain injury victims need surgery, physical therapy, occupational therapy, and other intensive treatment. The flat place on the top side L of my head is proof enough for me, as I now have had brain problems since I got older. At CognitiveFX, we have created a database of FNCI scans of patients who have never had a brain injury and who do not have symptoms of PCS (in other words, they have apparently normal brain function).

If you have ever heard of or seen a person who has suffered a concussion, you may have heard of it simply as a bruise of the brain. Because all patients with head injuries do not require imaging, the doctor will evaluate the patient and determine if a CT or MRI is needed. When left untreated, these injuries can cause long-term damage and increase the likelihood of degenerative disorders in the future. Although it is improving, technologies often fail to identify microscopic lesions in neurons and neural connections, often associated with mild brain injuries.

MRI imaging is also essential in the long-term therapy of traumatic brain injury and for identifying chronic conditions caused by a previous illness or injury, determining prognosis, and guiding rehabilitation. Insurance companies have lobbied against MRI after accidents because they know they can find a brain injury much more easily with a contrast MRI than with a CT scan. I retired earlier (as a career emergency nurse) than I wanted, as I realized that the brain was not as up-to-date as it had been and needed to be. Until recently, neurologists and physicians could not use an MRI to visualize the effects of mild traumatic brain injury or concussions, since a standard MRI could only detect substantial damage to brain tissue.

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