Persistent Post-concussive Symptoms (PPCS): Imaging and Treatment Strategies
Image 1. Diffusion tensor imaging of the brain (courtesy of researchgate.net)
Image 2. Functional MRI of the brain (courtesy of NYU.edu)
Image 3. Single Photo Emission Computed Tomography (SPECT) (courtesy of news-medical.net)
SPECT, or single-photon emission computed tomography, is a functional technique used to measure cerebral blood flow based on the distribution of a radiopharmaceutical that is injected intravenously (24). Tomographic images/3D images are constructed that represent cerebral activity (typically at rest) and is a sensitive tool for detecting regional abnormalities in brain function and relative cerebral blood blow. The cerebral blood flow (CBF) is an indirect measurement of brain metabolism and depends on comparison to normal tissue, which may be difficult in the setting of a concussion. SPECT has been shown to be more sensitive in detecting abnormalities with mild TBIs when compared to conventional MRI (25).
17. Aoki Y, Inokuchi R, Gunshin M, Yahagi N, Suwa H. Diffusion tensor imaging studies of mild traumatic brain injury: a meta-analysis. J Neurol Neurosurg Psychiatry. 2012; 83: 870–876
36. Kim, J. et al. Resting cerebral blood flow alterations in chronic traumatic brain injury: an arterial spin labeling perfusion FMRI study. J. Neurotrauma 27, 1399–1411 (2010).