What Happens When Brain Injuries are Missed on MRI and CT Scans?

There have been a lot of cases where patients have mild brain injuries that have gone undetected by CTs and MRIs. A better or more precise scan is too much expensive and not everybody opts for it.

And, to be clear your skull will actually look the same if you do or do not have any minor brain injury. According to our team’s research in a lot of cases, it has also been observed that patients had brain injuries but they were detected in the scans after a duration of 1-3 weeks. In the meantime, the problems have kind of grown already.

I’ll Tell You About the Working of CT Scan and MRI

If we see, scientifically available medical equipment that are present in laboratories or even hospitals. MRI and CT scans are the best apparatus for scanning lesions.

However, they perform in the best capacity for macroscopic or large lesions, not for microscopic problems. Injuries in the neurons or neural connections are not easily located and unfortunately, these are associated with the brain.

1. CT Scan

A CT scan which is also known as computerized tomography works in a fashion that it takes multiple X-ray images of your body from different angles. These images are first processed and then compiled by an external computer which then converts them into a big single picture.

Compared to a general X-ray, a CT scan provides way more detailed information about your bones, blood vessels, and even the soft tissues. This is why when you undergo an injury or wreck in your body, a doctor would probably suggest you take a CT scan so that any internal trauma can be detected.

2. MRI

An MRI or magnetic resonance imaging is basically a machine that uses magnetic fields and radio waves to create images of organs and tissues, with very detailed images. The most surprising element of this technology is that their working process is non-invasive, and the details obtained are very clear compared to CT scans.

However, due to the presence of magnetic fields in the working, a person who has metal or shrapnel in the body or medical device can not undergo an MRI scan. Even people who are scared of enclosed spaces can not undergo the same.

In an interview with the Icy Whiz team, David Pumphrey, CEO of Riveraxe LLC, emphasized the integration of machine learning in imaging. Since he closely works with healthcare professionals, he brings a new perspective. Here is what he said:

“In my experience working with health IT, and particularly within the realm of integrating machine learning into healthcare, advancements in imaging technology, especially through the application of machine learning algorithms like those found in SubtleMR and InnerEye, have shown tremendous potential in significantly improving the detection of subtle brain injuries. 

These advanced technologies can enhance the clarity of medical scans beyond what traditional CT and MRI scans can achieve.

By training deep learning models on vast datasets, these tools can detect minute changes that might be indicative of subtle brain injuries, changes that could easily go unnoticed by traditional methods.

For example, SubtleMR has been leveraged to enhance the quality of imaging, which is crucial for accurately diagnosing these types of injuries.

This not only reduces the need for repeat imaging, minimizing patient exposure to radiation but also aids in the early detection of injuries, which can be critical for effective treatment.

Similarly, InnerEye’s ability to analyze medical images with precision assists healthcare professionals in making accurate diagnoses, enabling timely and informed decisions regarding patient care.

To ensure accurate and timely diagnosis of subtle brain injuries, healthcare providers should integrate these advanced imaging technologies into their diagnostic processes while ensuring the data being used to train these machine learning models are of high quality and reflect a diverse range of injuries.

Continuous training and reevaluation of these models are vital to adapt to discoveries and improvements in medical science. 

Collaboration between IT professionals, clinicians, and machine learning experts is also essential to effectively implement these technologies, ensuring they complement, rather than replace, the critical decision-making process of healthcare professionals.

This synergy can drastically improve the detection and treatment of subtle brain injuries, ultimately enhancing patient outcomes.”

Can a Brain Bleed be Missed on a CT Scan? I’ll Tell You Why Brain Injuries Are Missed on Scans

Something we need to understand about traumatic brain injuries is that they may show obvious signs sometimes and other times they might not show any signs at all. But you must diagnose any such injury accurately and as soon as possible.

Because, it can lead to alteration in cognition, behavior, speech, hormones, vision, and even other internal organs thus affecting your normal body functions. And if these are not detected accurately and timely it might even lead to neurodegeneration leading to worse diseases.

Due to the symptoms not being very obvious, the diagnosis is also very difficult and complicated. It has been observed that over 75% of brain injuries go undetected on MRIs and CT scans.

If we see then the only foolproof way to diagnose a brain injury is to first get your scans done. Then those analyses to be followed by psychological and neuropsychological examinations; to actually get a clear picture of what is happening.

Andrew Pickett, Founder and Lead Trial Attorney at Andrew Pickett Law, shared his views on this in an interview with the Icy Whiz team. Here is what he had to say:

“Advancements in imaging technology, particularly in diffusion tensor imaging (DTI) and functional MRI (fMRI), hold great promise in identifying subtle brain injuries that traditional CT and MRI scans might overlook. 

These advanced methodologies can map and measure the diffusion of water in the brain’s white matter, providing insights into microscopic changes that occur at the cellular level—changes often indicative of trauma.

Also, fMRI can assess the brain’s functional connectivity and neural activity, offering a detailed view of how brain regions communicate, which could be altered following an injury.

From my perspective as a Trial Attorney, where accurate diagnosis of brain injuries can significantly impact the outcome of personal injury cases, the integration of these advanced imaging technologies into standard healthcare practices is crucial. 

Healthcare providers should engage in continuous education to stay abreast of these advancements and advocate for their availability in clinical settings.

Incorporating these technologies not only aids in accurate and timely diagnosis but also reinforces the credibility of evidence in legal proceedings, ensuring that justice is served for victims of traumatic brain injuries.”

Both Tools Have Some Limitations

As we have seen above, both MRI and CTs are very useful tools when it comes to the diagnosis of injuries, there are a few reasons for this. Tissue injuries are very interior in the body and can easily go unnoticed by an MRI or even a CT scan. Similarly, other abnormalities like these might also miss out on these scans.

Some traumatic brain injuries do not show up easily or quickly, indeed they might not occur even after days. So, if something is very small, implying microscopic, it can easily be missed including a microscopic brain bleed or damage in the nerve fiber.

There can be external factors affecting the accuracy of both your MRI and CT scans.

• If the radiologist who is assigned to assess the scans does not have enough experience or does not use the latest technology then he/she might miss out on identifying the exact injuries.
• If the scans that are being performed are not on the newest possible appliances, then you need to ask for a special contrast dye in the absence of which the scans will not clearly show the exact extent of damage.
• Another problem is that when a radiologist examines the scans, they do it with utmost precision but that does not imply that there is no scope for mistakes whatsoever.

Although they are trained professionals they can still make mistakes and one of the major reasons for that is having incomplete information, whenever you get any kind of scanning done MRI or CT.

Make sure that you provide the examiner with your previous reports and symptoms plus the causes of your injuries if any. This way they can interpret your scans better and provide you with a better analysis.

We interviewed Dr. Zev Schulhof, DMD, MD, Iconic Implants, to understand more about the advancements in imaging technology for accurate and timely diagnosis of such injuries. Here is what he said:

“Advancements in imaging technology have greatly improved our ability to detect and treat subtle brain injuries. Newer imaging techniques such as DTI and SWI are more sensitive than traditional methods such as CT and MRI.

As a result, medical professionals can detect injuries that may not be visible with these longstanding methods.

Advanced imaging of the brain also provides more detailed views of the brain’s structure and function, which further improves our ability to detect and treat abnormalities.”

As we have seen above brain injuries affect the body, they must be diagnosed and tracked well in time to prevent them from further degrading our bodies.

So, to accomplish this, make sure that not only do you get all your necessary scans done but also follow a proper neuropsychological examination to understand the literal situation. I am saying this because there can be cases where a scan might miss a brain bleed, and later affect you.

Guest Author: Saket Kumar

Last Updated on May 19, 2024 by Pragya