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Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
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ACR Appropriateness Criteria® Head Trauma: 2021 Update.

, Robert Y Shih1, Judah Burns2

  • 1Uniformed Services University, Bethesda, Maryland.

Journal of the American College of Radiology : JACR
|May 7, 2021
PubMed
Summary

Head trauma necessitates neuroimaging for diagnosis. Guidelines recommend selective CT scanning for mild head injuries, with MRI used for persistent deficits, guiding effective patient management.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaCTHead traumaMRITraumatic brain injury

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Area of Science:

  • Neurology
  • Radiology
  • Public Health

Background:

  • Head trauma is a major cause of death and disability in children and young adults.
  • Neuroimaging is crucial for managing head and brain injuries across acute, subacute, and chronic phases.
  • Mild head trauma constitutes over 75% of acute cases, often with normal Glasgow Coma Scale scores.

Framework:

  • Clinical practice guidelines recommend selective CT scanning for mild head trauma based on decision rules.
  • CT is the primary imaging modality for suspected intracranial injury.
  • MRI is valuable for unexplained persistent neurological deficits, particularly in subacute or chronic stages.

Implementation:

  • CT angiography is indicated for suspected vascular injury.
  • Thin-section CT of the skull base is used for suspected cerebrospinal fluid leaks.
  • The American College of Radiology Appropriateness Criteria provide evidence-based imaging guidelines.

Implications:

  • Guidelines ensure appropriate and timely neuroimaging for head trauma patients.
  • Selective imaging strategies optimize resource utilization and patient care.
  • Expert opinion supplements evidence when data is limited, ensuring comprehensive recommendations.