TY - JOUR PY - 2023// TI - Fluid biomarkers and neuroimaging in mild traumatic brain injury: current uses and potential future directions for clinical use in emergency medicine JO - Emergency medicine journal A1 - Newcombe, Virginia A1 - Richter, Sophie A1 - Whitehouse, Daniel P. A1 - Bloom, Benjamin Michael A1 - Lecky, Fiona SP - ePub EP - ePub VL - ePub IS - ePub N2 - Mild traumatic brain injury is a common presentation to the emergency department, with current management often focusing on determining whether a patient requires a CT head scan and/or neurosurgical intervention. There is a growing appreciation that approximately 20%-40% of patients, including those with a negative (normal) CT, will develop ongoing symptoms for months to years, often termed post-concussion syndrome. Owing to the requirement for improved diagnostic and prognostic mechanisms, there has been increasing evidence concerning the utility of both imaging and blood biomarkers.Blood biomarkers offer the potential to better risk stratify patients for requirement of neuroimaging than current clinical decisions rules. However, improved assessment of the clinical utility is required prior to wide adoption. MRI, using clinical sequences and advanced quantitative methods, can detect lesions not visible on CT in up to 30% of patients that may explain, at least in part, some of the ongoing problems. The ability of an acute biomarker (be it imaging, blood or other) to highlight those patients at greater risk of ongoing deficits would allow for greater personalisation of follow-up care and resource allocation.We discuss here both the current evidence and the future potential clinical usage of blood biomarkers and advanced MRI to improve diagnostic pathways and outcome prediction following mild traumatic brain injury.
Language: en
LA - en SN - 1472-0205 UR - http://dx.doi.org/10.1136/emermed-2023-213111 ID - ref1 ER -