CT scans are the most commonly used imaging tests. They are a series of X-ray images taken one slice at a time and combined to form images more detailed than a traditional X-ray. They are invaluable in the diagnoses of acute and life threatening problems and often used in emergency rooms when someone arrives with a head injury. They are superior to MRIs for viewing changes in the structure of the brain such as hemorrhages, lesions, subdural hematomas, and temporal bone, skull and face fractures.
CT Scans Are Not Perfect at Diagnosing Brain Injuries
However, they can miss signs of Traumatic Brain Injury (TBI) for various reasons. The findings on CT scans sometimes lag behind the actual injury if the test is performed too soon after the trauma, leading doctors to underestimate the extent of the injury. Damaged axons, which manage the transfer of information within the brain, are microscopic in size but the CT scanner doesn’t reproduce microscopic details so they often go unseen. CTs can also miss small amounts of blood because the images are taken one slice at a time and later combined. If a blood pool or other abnormality is smaller than the width of a slice, 5 to 10 mm generally, it may not show up on the images.
I recently learned of a case where a brain bleed was not discovered until months after the accident even though the patient had a CT of the brain done immediately. It went undetected until the bleeding had gotten severe enough to affect that person’s balance and required a follow up scan.
Even though CT scans miss certain things, they remain the prominent choice of doctors for immediate diagnosis and treatment of brain injuries for their quickness and accuracy in detecting life threatening conditions. A CT scan only takes about 15 minutes (or 30 minutes if contrast is used) to complete the test and be of use for doctors. For someone suffering from a stroke or aneurysm where time is crucial, the CT is a life saver.
In Certain Circumstances, Magnetic Resonance Imaging (MRI) May Be More Accurate and Effective
The story changes two to three days after trauma when MRI becomes more accurate at detecting slight abnormalities in the brain than CT scans. As blood ages it becomes denser and can look more like tissue on a CT. MRI scanners do not rely on density, but instead on magnetic charges and radio waves, so the changing composition of the blood does not impair the results.
When looking at the results of a CT scan you will see a grayscale image of the brain. The lighter in color something is, the denser the tissue, fluid or bone is. So, your skull will show up as white and the brain tissue will show up as different shades of gray with any gas or air appearing the darkest. Doctors use these shades to determine which areas are ‘not normal,’ such as a lesion, fluid, air or another mass in the brain instead of standard brain matter.
CT scans are undeniably vital in the diagnoses of potentially lethal injuries. They exist to rule out and diagnose problems that need to be treated immediately. Keep in mind, a ‘negative’ or ‘normal’ CT scan does not conclusively mean there is no brain damage, particularly when the patient has suffered a concussion or loss of consciousness. It is crucial that caregivers and patients carefully monitor and report any physical signs of brain injury (memory loss, balance issues, confusion, etc.) to a physician for a follow-up examination.
Misconception Regarding Brain Injury Medical Malpractice
It's important to note, to have a legitimate medical malpractice claim, your surgeon or doctor had to have been grossly negligent. This means they had to have completely misread or ignored the fundamental findings of your CT scan.
Have you suffered a serious brain injury due to negligence or an accident? You need to speak with an experienced personal injury attorney. Contact us online or call us directly at 888.815.6398. We will be happy to answer any questions during your free consultation.