Based on outcomes analysis, the authors conclude that patients with mild TBI with a small convexity contusion or extra-axial hemorrhage <10 mL do not require routine repeat CT or admission to the intensive care unit in the absence of neurologic deterioration [42]. In the presence of an abnormal initial CT, other patient factors such as intoxication or pharmacologic sedation often affect the reliability of serial examinations in the acute trauma setting and lower the threshold for follow-up imaging, even in the absence of neurologic deterioration. CTA Head and Neck There is no relevant literature to support the use of CTA in the short-term follow-up imaging evaluation of acute head trauma without suspected vascular injury (see Variants 8 and 9 when suspected). Please refer to discussion under Variants 8 and 9 on imaging risk factors that are associated with intracranial vascular injury and would support the use of CTA/CTV. FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the short-term follow-up imaging evaluation of acute head trauma. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of SPECT in the short-term follow-up imaging evaluation of acute head trauma. MR Spectroscopy Head There is no relevant literature to support the use of MRS in the short-term follow-up imaging evaluation of acute head trauma. MRA Head and Neck There is no relevant literature to support the use of MRA in the short-term follow-up imaging evaluation of acute head trauma. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI in the short-term follow-up imaging evaluation of acute head trauma. MRI Head Although brain MRI is not the most useful initial imaging modality for the evaluation of acute head trauma, it may be indicated as a follow-up study when there are persistent neurologic deficits that remain unexplained after the head CT [2].
Head Trauma PCAs. Based on outcomes analysis, the authors conclude that patients with mild TBI with a small convexity contusion or extra-axial hemorrhage <10 mL do not require routine repeat CT or admission to the intensive care unit in the absence of neurologic deterioration [42]. In the presence of an abnormal initial CT, other patient factors such as intoxication or pharmacologic sedation often affect the reliability of serial examinations in the acute trauma setting and lower the threshold for follow-up imaging, even in the absence of neurologic deterioration. CTA Head and Neck There is no relevant literature to support the use of CTA in the short-term follow-up imaging evaluation of acute head trauma without suspected vascular injury (see Variants 8 and 9 when suspected). Please refer to discussion under Variants 8 and 9 on imaging risk factors that are associated with intracranial vascular injury and would support the use of CTA/CTV. FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the short-term follow-up imaging evaluation of acute head trauma. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of SPECT in the short-term follow-up imaging evaluation of acute head trauma. MR Spectroscopy Head There is no relevant literature to support the use of MRS in the short-term follow-up imaging evaluation of acute head trauma. MRA Head and Neck There is no relevant literature to support the use of MRA in the short-term follow-up imaging evaluation of acute head trauma. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI in the short-term follow-up imaging evaluation of acute head trauma. MRI Head Although brain MRI is not the most useful initial imaging modality for the evaluation of acute head trauma, it may be indicated as a follow-up study when there are persistent neurologic deficits that remain unexplained after the head CT [2].