Role of Brain Perfusion Imaging (SPECT- Tc-99m HM-PAO) in Diagnostics and Follow-up in Diffuse Axonal Injury

Patients with diffuse axonal injury (DAI) may present an array of neurological and psychological symptoms. Magnetic resonance imaging (MRI) and computed tomography (CT) are clearly not sufficient to present the whole spectrum of underlying pathologies especially functional ones. The links between observed psychological changes and functional neuroimaging have not been fully established yet. Still unknown are the timing of DAI, which changes observed in different modalities (CT, MRI, SPECT) are primary (axons torn or severed at the time of injury and focal hemorrhagic lesions) or secondary (traumatic event only alter axonal function to elicit a local swelling followed by disconnection). This case report presents functional neuroimaging (SPECT- Tc-99m HMPAO) and psychological tests as a supplement to MRI and CT. Because of its sensitivity, functional neuroimaging may play an important role in the follow-up of mild DAI.