MRI in head injuries

Abstract

Trauma is the most common cause of death among children and infants, of which head injuries account for some 60%. The mortality and morbidity rates concerning primary lesions and posttraumatic sequelae in patients with head injuries have been considerably reduced by the advent of computed tomography (CT), which is still the examination technique of choice in the acute phase, thanks to the rapidity with which it can be performed, the ready availability of the imaging equipment and the absence of contraindications (6, 25, 29). The drawback of this technique is the difficulty encountered in detecting smaller lesions, which are often located at the grey-white matter junction or in the vicinity of bone (e.g., temporal and frontal lobe poles, posterior fossa). In certain cases, the patient's clinical condition can be quite in contrast with the information yielded on their respective CT examinations (4, 7). Due to its greater sensitivity in detecting these types of lesions, magnetic resonance imaging (MRI) can be used as a complement to or even a substitute for CT in some instances (5, 10, 14, 16, 18, 19, 24, 26). This said, performing an MR examination in the acute phase of trauma can prove somewhat difficult and entails a number of risks. These drawbacks, which will be discussed briefly below, make MR a technique of secondary importance in the overall imaging evaluation of head injuries (12). © 2006 Springer Berlin Heidelberg.