Mild traumatic brain injury (mTBI) is a common occurrence around the world, associated with a variety of blunt force and torsion injuries affecting all age groups. Most never reach medical attention, and the identification of acute injury and later clearance to return to usual activities is relegated to clinical evaluation-particularly in sports injuries. Advanced structural imaging is rarely performed due to the usual absence of associated acute anatomic/hemorrhagic changes. This review targets physiologic imaging techniques available to identify subtle blood-brain barrier dysfunction and white matter tract shear injury and their association with chronic traumatic encephalopathy. These techniques provide needed objective measures to assure recovery from injury in those patients with persistent cognitive/emotional symptoms and in the face of repetitive mTBI.
Keywords: 18-fluorodeoxyglucose positron emission tomography; arterial spin labeling MRI; blood–brain barrier dysfunction; chronic traumatic encephalopathy; diffusion tensor imaging MRI; dynamic contrast-enhanced (DCE) MR perfusion; mild traumatic brain injury; shear white matter injury.