Functional versus structural imaging in mild traumatic brain injury: The call for an accurate scan

In the early stages after a brain injury, a computed tomography (CT) scan is traditionally used as a clinical tool to quickly detect hemorrhaging, fractures, or lesions in the brain. Alternately, the magnetic resonance imaging (MRI) scan can offer varying levels of increased sensitivity that might better detect damage. The CT and MRI scans are used to assess changes in the structure of the brain and do not measure what happens when the brain is in action.

Positron emission tomography (PET) and functional MRI (fMRI) are two examples of scans that measure action. They have traditionally been used in research settings in order to determine changes in the brain while working at various tasks. Past research has shown direct associations of activity in different areas of the brain with specific tasks—leading to a surge of understanding about brain functioning. In cases of traumatic brain injury, functional scans have helped show that cognitive impairments can be associated with decreased activity in corresponding areas of the brain.

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Long-term consequences of traumatic brain injury

It is recognized that survivors of traumatic brain injury have to cope with numerous life challenges. The growing concern for the number of veterans returning with a brain injury has prompted a tremendous influx of research. These new studies contribute to the understanding of brain injury in both civilian and military populations.

The Institute of Medicine recently created a Committee on Gulf War and Health for Brain Injury in Veterans and Long-Term Health Outcomes. The results of their research reviews were published in the December 2009 issue of the Journal of Head Trauma Rehabilitation.

While many of the results should come as no surprise to people dealing with traumatic brain injury (for instance that TBI is associated with unemployment, depression, or cognitive deficits), the Committee also outlined health trends that are not as well known. Here we present a short summary of the Committee's findings on the social, cognitive, neurological, and psychiatric long-term outcomes after traumatic brain injury.

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