Brain and facial trauma: A neuroradiology perspective

Traumatic head and facial injuries are common causes of emergency department admissions. Head trauma, in particular, is the commonest reason for emergency out of hours computed tomography (CT) performed. Most patients with traumatic brain injuries (TBIs) have mild head injuries, but up to 20% require hospitalisation or further management. The fixed size of the bony cranial cavity means that only small increases in volume within the intracranial compartment can be tolerated before pressure within the cavity increases dramatically leading to secondary brain injury, with potentially catastrophic consequences. Head and brain injuries are commonly associated with facial trauma, particularly of the upper face, and it is important to be aware of this because the treatment of the former injuries may need to take precedence over the facial injuries. This review aims to summarise the epidemiology of blunt trauma to the head and face and the various patterns of TBI. The role of CT, both in the acute setting and in follow-up these patients, is described.