Brain injury, concussion, and SPECT

Transcript

Brain injury is not always obvious. Rapid acceleration, deceleration, or rotational forces can disrupt delicate brain tissue even when the head never strikes an object. Injury may also affect the blood-brain barrier.

Brain injury may result from trauma, toxic exposure, stroke, infection, inflammation, or loss of oxygen. Traumatic injury ranges from concussion—a mild TBI—to moderate or severe TBI.

During acute evaluation, CT—and, when indicated, MRI—can identify bleeding, fracture, and other structural injury.

When symptoms persist or recovery is prolonged, brain perfusion SPECT may add complementary information about regional cerebral blood flow and function. It does not establish a diagnosis by itself; findings must be interpreted with the history, symptoms, examination, and structural imaging.

Treatment depends on cause and severity and may include medication, physical, cognitive or vestibular rehabilitation, graded activity, and selected interventions. I have also evaluated brain perfusion before and after hyperbaric oxygen therapy.

Recovery varies. Most children with concussion improve within two to four weeks, but symptoms may persist, and moderate or severe injuries can have lasting effects.

When symptoms continue, examining both brain structure and function may contribute information that neither approach provides alone.