Bonfante E, Riascos R, eds. Mukherji SK, consulting ed. Neuroimaging Clinics of North America: Imaging of Brain Concussion. theclinics.com; 2018;28(1):1–136; $386.90

Cover of Bonfante

In this day and age when not a week goes by without news of another pro athlete being placed in a concussion protocol, without a whole movie being devoted to the topic, without chronic traumatic encephalopathy being part of the lay vernacular, and without traumatic brain injury (TBI) being on the rise, Neuroimaging Clinics of North America: Imaging of Brain Concussion is a timely publication. The lay media and the medical community have publicized the public health risk that traumatic brain injury and concussion represent, both short-term repercussions and long-term health effects. Even so, there remains confusion as to the difference between the two, debate about what the acute and chronic health consequences are, and difficulties in diagnosis. While much research needs to be continued to answer these questions, this issue of Neuroimaging Clinics sought to bring the radiologist up-to-date with their current role and potential future position in bringing clarity to this diagnosis and helping predict prognosis.

As is common to the series, this issue of Neuroimaging Clinics is organized into relatively concise review articles (11 in total) all addressing the common theme of mild TBI (mTBI) and concussion. After a brief introductory review article that establishes the scope of the problem and defines the differences and similarities between the two, the remaining 10 articles concentrate on the current roles of different imaging modalities in aiding in the diagnosis of mTBI and concussion, what the most contemporary research is uncovering about mTBI and concussion, and where that research may lead neuroimaging in the future in treating patients suffering from mTBI/concussion. There are articles focused on CT and MR perfusion, PET and SPECT nuclear medicine imaging, susceptibility imaging, functional MRI, and white matter tractography, of which diffusion tensor imaging is an example. Some articles address mTBI and concussion together, while others more specifically center on sports-related concussions. Some reviews address imaging of either the acute or the chronic phase of injury, while others take a more global approach. All in all, the issue is well-organized and comprehensive in its review of imaging of mTBI and concussion.

A neuroradiologist will find the topics covered in sufficient detail for a subspecialist. In fact, a few of the modality-specific articles give a more detailed explanation of the imaging physics than was expected for a review article. The multimodality nature of the articles may also reacquaint a neuroradiologist with imaging that they may not be as familiar with, especially if they practice in a private practice setting. Many articles also describe the research correlating imaging with neurocognitive testing, another topic that will help broaden the horizons of a subspecialist.

All the included images appear accurately reproduced and annotated. They appear to be thoughtfully included to support and help readers understand the main text. Likewise, the included charts and illustrations serve a didactic purpose, though some are more complicated, with captions that could have eased interpretation a bit more.

As one would expect for a collection of review articles, all articles are extensively referenced with the current publications. One or two articles even direct the reader to additional publications for further reading explicitly in the main text, obviating the need to search the comprehensive reference lists.

Overall, Imaging of Brain Concussion is a Neuroimaging Clinics of North America issue that is on point. Its target audience is the neuroradiology community, who should find this issue enlightening. Even though some of the articles discuss more esoteric imaging topics that may be outside the scope of all but the academic neuroradiologist, this text will appeal to a broader audience. Any physician who is interested in the topic or who may deal with mTBI or concussion in the clinical setting should find this issue useful; this includes neurologists, neurosurgeons, psychiatrists, emergency physicians, radiologists, and primary care physicians who may see the delayed presentations of patients with acute injury or care for patients with chronic sequelae.

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