Chapter 18 Perfusion and Susceptibility Weighted Imaging in Traumatic Brain Injury

Traumatic brain injury (TBI) affects the brain’s vasculature in addition to the brain tissue itself. The shape and orientation of blood vessels predisposes them to injury during trauma, which can lead to a host of sequelae. Here, we will discuss the detection, identification, and clinical relevance of cerebral microbleeds, small chronic deposits of hemosiderin that result from damage to small blood vessels, as well as other forms of vascular damage. Next, because the vasculature is necessary for supporting brain function, we discuss brain metabolism and methods of measuring venous oxygenation in the brain, as a marker for cerebral metabolism, as well as some examples in TBI populations. Finally, because brain tissue locally regulates blood flow based on metabolic activity, and because this relationship is known to be altered after injury, we cover methods and findings for assessment of changes in cerebral blood flow after TBI.