Brain Trauma

How Brain SPECT Imaging Can Help with Brain Trauma

• Identify if brain trauma was present

• Shows deficits often not seen by anatomical studies

• Identify which systems may be affected

• Help to direct treatment

• Help with special services or legal issues

• SPECT cannot date a trauma

The brain is very soft (think tofu) and it is housed in a really hard skull that has sharp bony ridges. Two million new brain injuries reported every year. Many go overlooked, because you do not necessarily have to lose consciousness in order to have a bad brain trauma. Consciousness is a brain stem phenomenon, if it is not hurt you may not lose awareness. Also, you do not even have to hit your head to have a brain injury, such as having a whiplash accident.

The impact of head trauma is often overlooked in psychiatry. Even minor head injuries to vulnerable parts of the brain can cause problems for years to come. After a significant brain injury there is a high incidence of depression, substance abuse, marital conflict, school underachievement, job related and legal problems.

SPECT is one of the best tools in evaluating functional deficits from brain trauma that are often not seen by other studies, leading to more understanding and effective treatments for patients. Typically, SPECT findings in head trauma include focal areas of decreased activity, often in a contra-coup pattern (such as decreased activity in the left anterior prefrontal cortex and right occipital lobe or the anterior and posterior aspects of a temporal lobe) and, in some cases, marked hyperactivity over the site of the injury.

Documentation of head injuries is essential for several reasons. For school age children and teenagers it allows them to receive more specialized services. Knowledge of the injuries is often essential for legal/insurance reasons. Patient and family understanding of the effects of brain trauma of enhances treatment compliance and a deeper understanding from family and support systems.

Here’s an example of a man who fell off the roof. It damaged the left side of his brain. A year after the injury his wife divorced him because she said she was afraid of him, his personality had changed. With the right treatment, he got much better. The sad thing, he told me, was that if he would have gotten the right help earlier, it may have saved his marriage.

Healthy		Roof Accident