A Negative CT or MRI May Not Rule Out a Traumatic Brain Injury
Imaging sensitivity, slice thickness, and timing all matter. A 'normal' scan does not mean no TBI occurred — particularly for mild TBI and concussion.
By Attorney Dan D'Angelo
Trial Lawyer · Brain Injury Advocate · Avid Cyclist
A negative or normal computed tomography (CT) or magnetic resonance imaging (MRI) does not rule out a traumatic brain injury. 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.
There are several reasons why imaging of the brain may appear to be 'normal' or negative for injury but a TBI may still have occurred.
Sensitivity of Imaging
The choice of imaging performed may not be sensitive enough to identify brain injury. A CT scan is good at detecting life-threatening bleeds and skull fractures but is not as sensitive as MRIs at detecting microscopic injuries like microbleeds and widespread injury to the axons and nerve fibers known as diffuse axonal injury that are typical of concussion and mild TBI. An MRI can capture images or slices as fine as 1 mm thick while CT images are about 3-5mm thick. The thicker slice of the CT is more likely than an MRI to skip over trauma buried between the image slices.
Timing
The timing of imaging can also be a factor. A bleed like a subarachnoid hemorrhage is transient and optimally evaluated immediately with CT while delays of a few hours or days could result in missing the window to identify the subarachnoid hemorrhage by CT. Imaging performed early during the acute phase is not likely to show brain atrophy from trauma that may appear later as more time passes.
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.
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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
