Objective: Detection of traumatic brain injury (TBI) is of vital importance in patients who apply to the emergency department with a history of trauma. The aim of initial imaging in patients with suspected TBI is to detect trauma-related injury quickly and accurately. In this study, the effectiveness of prospectively cranial computed tomography (CT) and fluid attenuation inversion recovery (FLAIR) and susceptibility weighted imaging (SWI) sequence magnetic resonance imaging (MRI) examination results of patients diagnosed with TBI in the emergency department in terms of bleeding detection was investigated in the light of the literature.
Patients and methods: Patients with traumatic brain injury who applied to the emergency department between 2016 and 2020 were included in this prospective study. Cranial CT and MRI images containing SWI-FLAIR sequence were taken on the same day, immediately after cranial CT, for a total of 500 patients.
Results: In our study, TBI was detected in 242 males (70.8%) and 100 females (29.2%), for a total of 342 patients. The mean age was 41.45, the mean GCS was 13.35. There was a history of trauma such as falling in 155 patients (45.3%), traffic accidents in 171 patients (50%), and trauma in 16 patients (4.7%). In the comparative evaluation of CT and FLAIR-SWI MRI examinations no bleeding was detected in the FLAIR-SWI sections of 239 patients who did not have bleeding on CT; however, bleeding was detected in FLAIR-SWI sections in 14 patients who did not have bleeding on CT.
Conclusions: FLAIR-SWI MR, which is a more reliable examination method, should be performed before control CT, especially in patients with incompatible clinical and admission CT.