[Radiological diagnosis in acute craniocerebral trauma].
OBJECTIVE
Head injury alone or in combination with multiple trauma is the main cause of death and severe disability in individuals under 45 years old. This review is intended to describe the relevant imaging modalities, to analyze their specific value and limitations and to illustrate the most important radiologic findings. The indications for diagnostic imaging within the context of an interdisciplinary linkage of diagnostic and therapeutic measures are discussed.


METHODS
Recent publications are analyzed and compared to the experiences of our own hospital. In terms of a critical synoptic assessment the currently best standard of care is described in consideration of an interdisciplinary care concept.


RESULTS
Radiologic imaging modalities crucially contribute to the complete injury assessment and provide an indispensable basis for any therapeutic decision. Comprehensive neuromonitoring and reliable demonstration of delayed or secondary brain damage is impossible without modern imaging technology. Computed tomography (CT) further continues to be the most important imaging modality, while magnetic resonance imaging despite it's partly superior diagnostic informations remains reserved to particular diagnostic problems.


CONCLUSIONS
Suitable constructive prerequisities, an interdisciplinary care concept and integration of the radiologist in hospital-adapted diagnostic and therapeutic algorithms significantly improves the outcome of patients with acute head injury. Beside the correct diagnosis itself the time to establish a diagnosis above all has a crucial impact on successful management and good outcome of these patients.
Rieger
J
J
Institut für Klinische Radiologie, Klinikum Innenstadt, Ludwig-Maximilians-Universität, Pettenkoferstr. 8a, 80336 München. jrieger@radin.med.uni-muenchen.de
Linsenmaier
U
U
Pfeifer
K J
KJ
Reiser
M
M
D015901:Angiography, Digital Subtraction; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D002533:Cerebral Angiography; D019091:Critical Pathways; D004636:Emergency Service, Hospital; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D008279:Magnetic Resonance Imaging; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed