Traumatic brain injury (TBI) is a leading cause of sustained physical, emotional, and behavioral deficits, commonly due to motor vehicle accidents, falls, workplace accidents, and medical errors. The Centers for Disease Control report that an estimated 5.3 million Americans live with disabilities associated with a TBI. The pathophysiology of TBI is not completely understood. Current neuroimaging techniques have limited sensitivity to detect physiological alterations caused by TBI. Mild, and some moderate, TBI can be difficult to diagnose because the injuries are often not visible on conventional acute MRI or CT scanning.

Approximately 70% of patients with TBI do not show visible lesions using conventional MRI or CT techniques. The absence of abnormality on conventional neuroimaging techniques in the majority of mild TBI patients, even with post-concussive symptoms and cognitive and/or behavioral deficits, illustrates the limited prognostic value of conventional neuroimaging techniques as well. Alternative methods that can be used to show the true extent of a TBI include Diffusion Tensor Imaging (DTI), functional MRI (fMRI), and magnetoencephalography (MEG). These advanced imaging techniques are available, but sometimes come at a higher price and often are not covered by insurance companies. However, improper diagnosis may limit a patient’s care and recovery from injury. With the help of an experienced injury attorney, it is crucial to obtain the financial compensation deserved, in order to receive the best in care.

Axonal injuries, a major factor for the cognitive and behavioral deficits in TBI patients, are commonly induced by sudden acceleration-deceleration and/or rotational forces. The subsequent tissue injury is characterized by axonal stretching, disruption, and eventual separation of nerve fibers. Diffusion tensor imaging (DTI), an imaging technique based on the Brownian motion of water through tissues, measures the dependence of water diffusivity on tissue microstructure. Unlike conventional MRI, which is primarily sensitive to bleeding from nearby torn capillaries, but not to axonal damage itself, DTI provides a more direct measure of the integrity of the white matter fibers. It is suggested that axonal injury due to tissue shearing and stretching is a leading cause of persistent post-concussive symptoms in mTBI. The bleeding is only indirectly related to the axonal injury, and the sensitivity for detecting bleeding decreases quickly over time— approximately 2 weeks. Time is of the essence to ensure maximal recovery. In several research studies, DTI has been successfully applied in TBI cases. It is important to be educated about all of the options available for diagnosis and care. Contacting a personal injury lawyer early can help save you and your family the worry about financial burden, so that you can focus on recovering your health.