Abstract

Objective:
To evaluate the use of neuroimaging techniques in concussive injury in sport.

Methods:
15 subjects underwent brain CT, conventional MRI, FLAIR and Diffusion weighted MRI imaging (DWI) after sustaining a concussion during sport activity. Concussions were graded using the severity scale of the American Academy of Neurology (AAN).

Results:
33% of subjects studied had abnormalities on conventional MR or DWI studies. Findings were seen in low grade injuries and were not associated with initial LOC.

Conclusions:
These findings are among the first objective evaluations described in low grade concussive injury. The addition of DWI to the investigation protocol may increase yield
for otherwise occult lesions not detected on routine spin-echo MR images nor CT.

until now, the neuroimaging of most low grade concussions has revealed few abnormalities. CT has offered little in the way of positive findings and is therefore of limited use in concussion investigation and management issues. In general, this has led to problems objectively evaluating the degree of injury, assessing long term consequences, understanding the anatomy and pathophysiology of the injury and scientifically formulating return to play decisions. The findings described in this paper are among the first descriptions of positive neuroimaging in low grade concussion and identify a potentially important investigative tool. The addition of DWI to concussion evaluation may provide new and valid information to our protocol.

MRI is well known to be superior to CT in morphological assessment of brain lesions. Even so, until now, CT and MRI studies performed on subjects with post concussion syndrome were reported positive in only 9% of cases ²⁵. Our study identified positive findings

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