P0191 - The Efficacy of Neuroimaging in Adolescent Patients with Concussions

Background: The purpose of this study is to investigate the efficacy of the supplemental information neuroimaging, specifically magnetic resonance imaging (MRI) for persistent symptoms, provides after mild traumatic head injury.

Methods: Patients diagnosed with a concussion at our institute were prospectively enrolled into a repository. 636 patient charts were reviewed to identify if patients received an MRI, when they received neuroimaging, and final radiologist impressions of the imaging.

Results: 18.2% patients (116/636) received an MRI. The average time between injury and date of MRI was 72.9 days (range: 0 to 370 days). 27.5% (32/116) of patients received an MRI within 21 days of injury and 72.4% (84/116) of patients received an MRI greater than 21 days after injury. 23.2% (27/116) of patients had positive findings on their initial MRI. 76.7% (89/116) of patients had normal or insignificant findings on their MRI. There was no significant difference in days since injury between those that had positive findings on MRI compared to those that had an unremarkable MRI findings, t(114) = -0.04, p =. 965863.
Of the patients with positive findings, 40.7% (11/27) of patients received an MRI within 21 days of injury and 59.3% (16/27) of patients received an MRI greater than 21 days after injury. 96.2% (26/27) of patient with positive findings were referred to specialists for further workup. The average time between injury and date of MRI for patients with positive findings was 73.4 (range: 0 to 370 days). See Table 1 for findings.
Notably, those with MRI performed at >21 days did not demonstrate significant brain bleed or abnormalities that necessitated urgent intervention.

Conclusion: MRI was normal or demonstrated low yield with insignificant findings in 76.7% (89/116) of the patients. Further studies to elucidate best utilization of neuroimaging are recommended.