Can MRI and CT Scans Look Normal After a Brain Injury?

Dec 21, 2017
by Adler Markoff & Associates

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    Can MRI and CT Scans Look Normal After a Brain Injury?

    If you’ve suffered head trauma in a car accident, you might be suffering from all sorts of physical and mental symptoms. However, maybe the doctor at the emergency room didn’t diagnose you with a brain injury; maybe they even ordered a CT or MRI scan and it came back normal. 

    Now, you may be feeling confused and helpless — you know something isn’t right, but the doctor said your test results were normal. Can MRI and CT scans fail to detect a traumatic brain injury (TBI)? And is there anything you can do to get help?

    The answer to both of these questions is yes. Before you give up on a brain injury diagnosis and the chance to receive compensation for your medical bills and losses, read on to learn about how TBIs develop and how doctors diagnose them as well as where you can turn for help.

    What Is a Traumatic Brain Injury (TBI)?

    Each year, about 1.6 million Americans suffer a TBI. These injuries frequently occur during a car, truck, bus, motorcycle, or other serious motor vehicle accident.

    TBIs happen when trauma, such as whiplash or hitting your head against an object, causes brain tissue to bruise or tear. This results in bleeding, swelling, and damage to nerve fibers and brain matter. Since your brain tissue cannot repair itself, any damaged or dead tissue can lead to permanent dysfunction.

    Common symptoms of a traumatic brain injury include:

    • Amnesia (memory loss)
    • Headache
    • Vomiting
    • Loss of consciousness
    • Mood and personality changes
    • Problems with concentration and attention
    • Sensory processing problems
    • Visual disturbances, such as blurred vision

    However, TBI symptoms vary widely from case to case since the symptoms depend on the severity and location of the injury in addition to other factors. While many TBI victims eventually recover from their injury, brain injuries frequently require intensive medical treatment and rehabilitation. And some victims never fully recover from a TBI.

    Immediately after an accident, first responders and doctors will look for signs of an acute (meaning obvious and urgent) TBI. However, many TBIs are difficult to detect at first, especially if they are less acute in nature. Doctors sometimes call these less-acute brain injuries concussions or “mild” TBIs; however, this name is very misleading, as even a “mild” brain injury can involve significant damage to nerve fibers and brain tissues and may cause serious functional difficulties.

    What Are MRI and CT Scans?

    MRI and CT scans are diagnostic imaging studies that can help doctors identify and diagnose all kinds of injuries, including brain injuries. While both types of scans are commonly used to detect TBIs, they use different methods.

    • Computed tomography (CT) scan: Technicians take a series of x-rays of your head or another body part (or even your whole body). Computer software interprets and compiles the resulting images into a single picture. While generally safe, CT scans expose patients to significant doses of radiation, which does come with some risks since radiation exposure is known to cause cancer in humans.
    • Magnetic resonance imaging (MRI): During an MRI, magnetic fields, radio frequencies, and computer software work in tandem to create an image of your brain or another body part. MRIs are very powerful tests that show a greater level of detail in soft tissues compared to CT scans. However, some people cannot tolerate a lengthy MRI scan.

    If there’s concern about a brain injury after a serious accident, doctors typically order a CT scan first. CT scans are good at identifying skull fractures, severe brain bleeds, and other life-threatening injuries quickly. However, an MRI is better at identifying microscopic injuries to nerve fibers.

    The Limitations of MRIs and CT Scans in TBI Cases

    Not all TBIs show up in a diagnostic test such as an MRI or CT scan. In fact, less than 10% of people with “mild” TBIs have abnormal MRI or CT results. CT scans, in particular, often fail to accurately capture the severity of a TBI.

    This occurs for several reasons. First, CT scans are relatively poor at identifying soft tissue injuries. As a result, CT scans on average miss 10–20% of abnormalities that an MRI would detect.

    Second, TBIs can take time to develop on a physical level. A microscopic brain bleed might not appear on a CT scan for hours or even days, for example. And MRI scans aren’t foolproof, either. Not every MRI scan will show the true extent of nerve fiber damage or other microscopic brain trauma.

    Third, an MRI or CT test is only as good as the imaging machine and the radiologist interpreting it. While new MRI technology is increasingly capable of identifying microscopic brain damage, most hospitals do not have these newer, cutting-edge MRI machines. If your scan was performed on an older machine or your physician did not request special contrast dye, your MRI or CT scan might not show nerve fiber trauma and other brain injuries.

    Unfortunately, most doctors and insurance companies simply rely on the radiologist’s written interpretation of the scan. While most radiologists are competent professionals who do their best to accurately read MRI and CT results, mistakes can occur in all sorts of ways. For example, a radiologist might not have access to your full chart, including your complaints of symptoms and the nature of your accident, which might affect his or her interpretation of your CT or MRI scan.

    If My MRI or CT Scan is “Normal,” Do I Still Have a Personal Injury Case?

    You may have a valid personal injury claim related to a brain injury, even if your diagnostic tests came back “normal.” A TBI is a clinical diagnosis, and it should be based on several factors, including:

    • The facts surrounding your accident
    • Your reported symptoms
    • Physical exam findings
    • Neuropsychological assessments
    • Diagnostic studies

    Your doctor shouldn’t base your diagnosis on a single imaging scan. If you have multiple other signs of a TBI, a doctor can decide to diagnose you with a TBI, even if your MRI scan seems normal.

    Unfortunately, insurance companies frequently use a “normal” MRI or CT scan to deny accident claims. TBI claims are typically expensive since many brain injury victims need surgery, physical therapy, occupational therapy, and other intensive treatment. To cut costs, insurance companies look for any reason to dispute TBI claims.

    If you believe your traumatic brain injury claim was improperly denied, you should immediately contact a law firm that has experience and a track record of success handling complex brain injury cases.

    AMA Law: Experienced Brain Injury Lawyers Fighting for TBI Victims in Oklahoma

    A “normal” CT or MRI result and a denial from the insurance company isn’t the last word on your brain injury case. If you’ve suffered head trauma in a motor vehicle accident or other incident and you’re experiencing brain injury symptoms, we’re here to help. For more than 20 years, the dedicated team of attorneys at AMA Law has represented Oklahoma brain injury victims with personal injury and Social Security disability claims.

    If you have questions about traumatic brain injuries or your legal rights after an accident, contact our offices today for a free evaluation of your case. If we’re able to take your case, you won’t pay any attorney’s fees unless we help you achieve a settlement or we win your case in your court.

    To schedule your free case evaluation today, simply complete our easy online contact form or call us at 405-607-8757.


    Lee, B. Neuroimaging in traumatic brain imaging (2005, April). NeuroRX. Retrieved from

    Traumatic brain injury and concussion. American Society of Neuroradiology. Retrieved from

    The content provided here is for informational purposes only and should not be construed as legal advice on any subject.

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