--- title: "Negative CT or MRI Doesn't Rule Out a TBI" description: "Imaging sensitivity, slice thickness, and timing all matter. A 'normal' scan does not mean no TBI occurred, particularly for mild TBI and concussion." lang: en json-ld: | [ { "@context": "https://schema.org", "@type": "LegalService", "@id": "https://bikebrainlaw.com/#organization", "name": "Colorado Brain Injury & Bike Crash Attorneys | Bike Brain Law", "description": "Colorado brain injury and cycling accident attorneys serving Denver, Boulder, Fort Collins and statewide. Specialized TBI representation. Free consultation. Call 303.831.1116.", "url": "https://bikebrainlaw.com", "image": "https://bikebrainlaw.com/og-image.png" }, { "@context": "https://schema.org", "@type": "BlogPosting", "@id": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi#blogposting", "isPartOf": { "@type": "Blog", "@id": "https://bikebrainlaw.com/blog#blog", "name": "Bike Brain Law Blog" }, "mainEntityOfPage": { "@type": "WebPage", "@id": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi" }, "url": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi", "headline": "A Negative CT or MRI May Not Rule Out a Traumatic Brain Injury", "name": "A Negative CT or MRI May Not Rule Out a Traumatic Brain Injury", "description": "Imaging sensitivity, slice thickness, and timing all matter. A 'normal' scan does not mean no TBI occurred, particularly for mild TBI and concussion.", "image": { "@type": "ImageObject", "@id": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi#primaryimage", "url": "https://bikebrainlaw.com/images/content/img_7090.jpg", "contentUrl": "https://bikebrainlaw.com/images/content/img_7090.jpg", "caption": "Brain imaging scans on a medical lightbox", "description": "Brain imaging scans on a medical lightbox", "representativeOfPage": true }, "primaryImageOfPage": { "@type": "ImageObject", "@id": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi#primaryimage", "url": "https://bikebrainlaw.com/images/content/img_7090.jpg", "contentUrl": "https://bikebrainlaw.com/images/content/img_7090.jpg", "caption": "Brain imaging scans on a medical lightbox", "description": "Brain imaging scans on a medical lightbox", "representativeOfPage": true }, "thumbnailUrl": "https://bikebrainlaw.com/images/content/img_7090.jpg", "datePublished": "2025-12-18T15:00:00.000Z", "dateModified": "2025-12-18T15:00:00.000Z", "inLanguage": "en-US", "articleSection": "Brain Injury", "keywords": "Brain Injury, Colorado, personal injury, TBI, cycling accident", "timeRequired": "PT1M", "articleBody": "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.", "commentCount": 0, "additionalProperty": [ { "@type": "PropertyValue", "name": "readingTime", "value": "1 min read", "unitText": "minutes", "unitCode": "MIN" }, { "@type": "PropertyValue", "name": "wordCount", "unitText": "words" }, { "@type": "PropertyValue", "name": "characterCount", "value": 1607, "unitText": "characters" }, { "@type": "PropertyValue", "name": "headingCount", "value": 2 }, { "@type": "PropertyValue", "name": "paragraphCount", "value": 5 }, { "@type": "PropertyValue", "name": "listCount", "value": 0 } ], "author": { "@type": "Person", "@id": "https://bikebrainlaw.com/#dan-dangelo", "name": "Attorney Dan D'Angelo", "jobTitle": "Trial Lawyer · Brain Injury Advocate · Avid Cyclist", "description": "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.", "image": { "@type": "ImageObject", "url": "https://bikebrainlaw.com/images/content/20231015_dangelo_dan_square_076.jpg", "contentUrl": "https://bikebrainlaw.com/images/content/20231015_dangelo_dan_square_076.jpg", "caption": "Attorney Dan D'Angelo" }, "url": "https://bikebrainlaw.com/#about", "worksFor": { "@id": "https://bikebrainlaw.com/#organization" } }, "publisher": { "@id": "https://bikebrainlaw.com/#organization" } }, { "@context": "https://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://bikebrainlaw.com" }, { "@type": "ListItem", "position": 2, "name": "Blog", "item": "https://bikebrainlaw.com/blog" }, { "@type": "ListItem", "position": 3, "name": "A Negative CT or MRI May Not Rule Out a Traumatic Brain Inju", "item": "https://bikebrainlaw.com/blog/negative-imaging-does-not-rule-out-tbi" } ] } ] --- [![Bike Brain Law](/assets/logo-white-CuISKEAM.webp)](/)[303.831.1116](tel:3038311116) Practice Areas Practice Areas - [Brain Injury Focused brain injury representation backed by science, trial experience, and real results. ](/practice-areas/traumatic-brain-injury) - [Cycling Accidents An avid cyclist who fights for injured riders across Colorado. ](/practice-areas/cycling-accidents) - [Bicycle Product Liability Holding manufacturers accountable when defective bike parts cause injuries. ](/practice-areas/bicycle-product-liability) Resources - [Insights & Guides ](/blog) - [Case Results ](/results) - Our Process - FAQs Service Areas - [Denver](/service-areas/denver) - [Boulder](/service-areas/boulder) - [Fort Collins](/service-areas/fort-collins) - [Golden](/service-areas/golden) - [Colorado Springs](/service-areas/colorado-springs) - [Aurora](/service-areas/aurora) Featured [ ![Attorney Dan D'Angelo](/assets/dan-dangelo-headshot-DJ4GY3yR.jpg) Meet Attorney Dan D'Angelo Trial lawyer, trusted brain injury advocate, avid cyclist. Learn more ](/) Free consultation · No fee unless we win. Talk to Dan AboutTestimonials[Results](/results)FAQsContact[Insights & Guides](/blog)Free Consultation [](tel:3038311116) [All articles](/blog) [Brain Injury](/blog/brain-injury)· December 18, 2025· 1 min read # 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. ![Dan D'Angelo](/images/content/20231015_dangelo_dan_square_076.jpg) By Attorney Dan D'Angelo Trial Lawyer · Brain Injury Advocate · Avid Cyclist ![Brain imaging scans on a medical lightbox](/images/content/img_7090.jpg) 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. Related from Bike Brain Law - [Traumatic Brain Injury Claims How we build winning TBI cases against insurers. ](/#practice-areas) - [TBI & Injury FAQs Answers to the questions brain injury victims ask most. ](/#faqs) - [Our Case Process What to expect from consultation to settlement. ](/#process) Free, confidential case review ### Injured in a brain injury or serious accident in Colorado? Talk directly with Attorney Dan D'Angelo for a free consultation with zero obligation to find out where you stand. [Get My Free Consultation](/#contact) [303.831.1116](tel:3038311116) ## 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. ## Have a question about your case? Attorney Dan D'Angelo offers free consultations for brain injury and cycling accident victims throughout Colorado. [Free Consultation](/#contact) [303.831.1116](tel:3038311116) ![Dan D'Angelo](/images/content/20231015_dangelo_dan_square_076.jpg) 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 ## Related articles [ ![Brain imaging scans on a medical lightbox](/images/content/img_7090.jpg) #### Can a Denver Attorney Take My Traumatic Brain Injury Case to Trial? ](/blog/can-a-denver-attorney-take-my-tbi-case-to-trial)[ ![Racks of bicycles at a train station](https://odfyhkstsknriaebnttc.supabase.co/storage/v1/object/sign/blog-images/4aa19bbd-3cb5-4c36-a7ac-e40bf22d19ed.jpeg?token=eyJraWQiOiJzdG9yYWdlLXVybC1zaWduaW5nLWtleV81NTc3MTNiMy1mM2NiLTRjZmEtYmM3Yi0wYmQ0NmVmZjE3ZjIiLCJhbGciOiJIUzI1NiJ9.eyJ1cmwiOiJibG9nLWltYWdlcy80YWExOWJiZC0zY2I1LTRjMzYtYTdhYy1lNDBiZjIyZDE5ZWQuanBlZyIsInNjb3BlIjoiZG93bmxvYWQiLCJpYXQiOjE3ODUzNDY3NTksImV4cCI6MjEwMDcwNjc1OX0.xJyXEWuIgBqj1qmDqQQdai23W09gRBBqooyEtV3uisw) #### Why loss of consciousness is difficult to spot and why it's so important to your legal case. ](/blog/why-loss-of-consciousness-is-difficult-to-spot-and-how-to-identify-it)[ ![Treelined path with cyclist posing at the end](https://odfyhkstsknriaebnttc.supabase.co/storage/v1/object/sign/blog-images/55e622d3-709b-4210-a141-ac41b5765070.jpg?token=eyJraWQiOiJzdG9yYWdlLXVybC1zaWduaW5nLWtleV81NTc3MTNiMy1mM2NiLTRjZmEtYmM3Yi0wYmQ0NmVmZjE3ZjIiLCJhbGciOiJIUzI1NiJ9.eyJ1cmwiOiJibG9nLWltYWdlcy81NWU2MjJkMy03MDliLTQyMTAtYTE0MS1hYzQxYjU3NjUwNzAuanBnIiwic2NvcGUiOiJkb3dubG9hZCIsImlhdCI6MTc4NTM1MDA4MiwiZXhwIjoyMTAwNzEwMDgyfQ.y_WQrz9NT3BkAoSyOlpdMw9IrxR3LDOQRK0TKozc9dA) #### How long do brain injury symptoms last? ](/blog/how-long-do-brain-injury-symptoms-last) [![Bike Brain Law](/assets/logo-white-CuISKEAM.webp)](/) Colorado's dedicated brain injury and cycling accident attorney. 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