Is Radiology Imaging Needed to Diagnose a TBI?
No. TBIs, especially mild ones, are diagnosed using clinical factors like loss of consciousness, post-traumatic amnesia, and Glasgow Coma Scale.
By Attorney Dan D'Angelo
Trial Lawyer · Brain Injury Advocate · Avid Cyclist
No. Imaging of the brain by computed tomography (CT) or magnetic resonance imaging (MRI) is not required to diagnose a traumatic brain injury. Instead, a TBI, especially on the milder end, is often diagnosed without imaging based on other factors that include loss of consciousness, alteration of consciousness or mental state, post-traumatic amnesia, or Glasgow Coma Scale score. Imaging can be negative or considered normal for mild, moderate, or even severe TBIs, but would be atypical for a severe TBI to be normal.
A CT scan if performed, is usually done during the acute phase (approximately 1 – 7 days) after a head injury because it's cost effective, quick, and good at detecting life-threatening bleeds and skull fractures. A CT uses x-rays and takes about 10 minutes. A CT may not be performed when a concussion or mild TBI is suspected because the likelihood of a positive finding is usually outweighed by the risk of radiation exposure, cost, and busy ERs need the CT machine for other more seriously injured patients.
MRIs are more sensitive at measuring subtle or finer brain tissue damage such as microbleeds, diffuse axonal injury and metabolic changes that CTs cannot detect. MRIs take longer to perform than a CT and are generally more expensive. MRI does not use radiation, and there are numerous types of MRIs with varying sensitivity levels and advanced techniques. MRIs are generally performed after the acute phase and when symptoms persist.
Understanding these differences about imaging and how imaging plays a role in diagnosing and proving traumatic brain injury is vital to protecting the legal rights of brain injury victims and our clients. At Bike Brain Law, we are committed to working with expert radiologists and neuroradiologists and staying knowledgeable about the latest in brain imaging science to protect our client’s rights.
Frequently Asked Questions
Can a TBI be diagnosed without a CT scan or MRI?
Yes. Especially on the milder end, TBI is often diagnosed clinically — based on loss of consciousness, altered consciousness or mental state, post-traumatic amnesia, or Glasgow Coma Scale score — without any imaging at all.
Why was I diagnosed with a TBI but my CT scan considered normal?
CT scans are good at catching life-threatening bleeds and skull fractures, but they can't detect microbleeds, diffuse axonal injury, or metabolic changes that can still occur with brain injury. The normal imaging may rule out a bleed but does not rule out a TBI may have occurred.
When is a CT used versus an MRI for brain injury?
CT is typically done in the acute phase (about 1–7 days) because it's faster, cost-effective, and catches emergencies like brain bleeds. An MRI is more sensitive to subtle tissue damage, takes longer, costs more, and uses no radiation. MRIs are typically ordered later when post concussion symptoms may persist.
Can brain imaging help prove my injury in a legal case?
It can, but a "normal" scan doesn't disprove a TBI either. Understanding which imaging to get, when, and how to interpret it is critical — we work with expert radiologists and neuroradiologists and stay current on the latest brain imaging science to protect our clients. If your scan was normal but you are still experiencing symptoms, call me.
Have a question about your case?
Attorney Dan D'Angelo offers free consultations for brain injury and cycling accident victims throughout Colorado.
About the Author
Attorney Dan D'Angelo
Trial Lawyer · Brain Injury Advocate · Avid Cyclist
Attorney Dan D'Angelo founded D'Angelo Law Office, P.C. in 2009 and Bike Brain Law to focus exclusively on traumatic brain injury and cycling injury cases in Colorado. An avid cyclist himself, Dan combines deep TBI science knowledge with hands-on cycling experience to build winning cases against insurance companies and corporations that put profits over safety.
- Practicing Colorado personal injury attorney since 2009
- Focused practice in TBI and bicycle injury litigation
- Multi-million dollar settlements and verdicts for injury victims
- Avid road and commuter cyclist
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