Semin Neurol
DOI: 10.1055/a-2709-6750
Review Article

The Role of Neuroimaging in Traumatic Brain and Spinal Cord Injury

Authors

  • J. Palmer Greene

    1   Division of Neurocritical Care, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, United States
  • Erika J. Sigman

    1   Division of Neurocritical Care, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, United States
  • Jamie Podell

    2   Department of Neurology, Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland, United States
  • Catherine S.W. Albin

    1   Division of Neurocritical Care, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, United States

Abstract

Traumatic brain injury and traumatic spinal cord injury are major causes of morbidity and mortality, necessitating rapid and accurate diagnostic evaluation. Neuroimaging plays a critical role in the early assessment and management of these conditions, allowing for the timely identification of hemorrhagic lesions, cerebral edema, vascular injuries, and spinal cord pathology that may require urgent intervention. In this review, we use a time-based approach to appraise the role of imaging in the hyperacute (first 24 hours) and acute (up to 1 week) periods postinjury. Although computed tomography imaging guides most decision-making in trauma, we also highlight the role of ultrasound imaging modalities such as transcranial Doppler and optic nerve sheath diameter monitoring for noninvasive ICP monitoring, and magnetic resonance imaging for prognostication. Cases are used to highlight imaging findings that may change management in the hyperacute and acute period.



Publication History

Received: 14 August 2025

Accepted: 24 September 2025

Article published online:
21 October 2025

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