Magnetic Resonance Imaging in Severe Head Injury: Comparison with Computed Tomography.

Shin, Won Han; Lee, Jeong Hoon; Choi, Soon Kwan; Byun, Bark Jang; Lee, In Soo

Original Article

Journal of Korean Neurosurgical Society 1990;19(5): 593-600.

Won Han Shin, Jeong Hoon Lee, Soon Kwan Choi, Bark Jang Byun, In Soo Lee

Department of Neurosurgery, College of Medicine, Soonchunhyang University, Seoul, Korea.

ABSTRACT

Magnetic resonance imaging(MRI) and computed tomography(CT) in 30 patients with severe head trauma were compared. MRI was superior to CT in detection of intracerebral and extracerebral traumatic lesions. The results obtained were as follows : 1) 27 intracerebral(18 cerebral contusions, 5 diffuse axonal injuries & 4 intracerebral hematomas) and 13 extracerebral traumatic lesions(4 acute epidural hematomas, 4 subdural hygromas, 2 subarachnoid hemorrhages, 1 acute subdural hematoma, 1 chronic subdural hematoma & 1 pneumocephalus) in 30 patients were seen on CT and/or MRI. 2) Group I lesions which seen on MRI and not seen on CT were 5 diffuse axonal injuries(100%), & 8 cerebral contusions(44%), and group II lesions which seen on CT and MRI with better visualization on MRI were 6 cerebral contusions(33%), 2 intracerebral hematomas(50%), & 3 subdural hygromas(75%). 3) Group III lesions which seen on CT and MRI equally well were 4 cerebral contusions(22%), 2 intracerebral hematomas(50%), 2 acute epidural hematomas(50%), 2 subarachnoid hemorrhages(100%), 1 chronic subdural hematoma(100%), 1 subdural hygroma(25%) & 1 pneumocephalus(100%). 4) Group IV lesions which seen on CT and MRI with better visualization on CT were 2 acute epidural hematomas(50%), & 1 acute subdural hematoma(100%), and lesion which seen on CT and not seen on MRI was not. 5) 21 intracerebral lesions of group I and II were located on temporal(11), parietal(3), frontal(2) and occipital lobes(2), basal ganglia(1), brain stem(1) and cerebellum(1). 6) We recommended MRI in the acute stage of severe head trauma for accurate diagnosis and evaluation of intracerebral traumatic lesions, especially diffuse axonal injuries and cerebral contusions, which were not visualized clearly on CT.

Key Words: Severe head trauma; MRI; CT; Intracerebral trumatic lesions; Diffuse axonal injury; Cerebral contusion