Neuroim
aging pl
ays
an import
ant role in the m
an
agement of he
ad tr
aum
a. Sever
al guidelines h
ave been published for identifying which p
atients c
an
avoid neuroim
aging. Noncontr
ast he
ad CT is the most
appropri
ate initi
al ex
amin
ation in p
atients with minor or mild
acute closed he
ad injury who require neuroim
aging
as well
as p
atients with moder
ate to severe
acute closed he
ad injury. In short-term follow-up neuroim
aging of
acute tr
aum
atic br
ain injury, CT
and MRI m
ay h
ave complement
ary roles. In sub
acute to chronic tr
aum
atic br
ain injury, MRI is the most
appropri
ate initi
al ex
amin
ation, though CT m
ay h
ave
a complement
ary role in select circumst
ances. Adv
anced neuroim
aging techniques
are
are
as of
active rese
arch but
are not considered routine clinic
al pr
actice
at this time. In suspected intr
acr
ani
al v
ascul
ar injury, CT
angiogr
aphy or venogr
aphy or MR
angiogr
aphy or venogr
aphy is the most
appropri
ate im
aging study. In suspected posttr
aum
atic cerebrospin
al fluid le
ak, high-resolution noncontr
ast skull b
ase CT is the most
appropri
ate initi
al im
aging study to identify the source, with cisternogr
aphy reserved for problem solving.
abspara0015">The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every three years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.