Imaging findings for severe traumatic brain injury.

Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in young patients. The Marshall classification predicts six-month mortality and divides severe TBI patients into six groups based on CT findings in the acute phase of trauma. MRI also has prognostic value because it detects 30% more traumatic lesions, especially brainstem injury and diffuse axonal injury. Diffuse axonal injury occurs in three different anatomical areas, graded according to severity, and the greater the trauma, the deeper the brain involvement extends. Traumatic brainstem injuries with the worst prognosis are those of posterior location, with bilateral or haemorrhagic involvement. This article analyses the prognostic value of CT and MRI in the assessment of severe TBI and describes the main intracranial traumatic injuries.