One of the hardest parts of a traumatic brain injury (TBI) claim is that the injury may not show up on a standard scan. A person can have a normal CT or MRI while they are in the emergency room and still have real, disabling symptoms. That gap between what a routine scan shows and what the person is living with is where brain injury imaging can make a difference in a case.
When advanced imaging is properly performed and interpreted, it may provide objective evidence that supports other medical findings. But it isn’t a guaranteed way to prove a TBI. Our Denver brain injury trial lawyers understand the role imaging plays in telling your story to a jury and seeking compensation.
Let’s explore the role of advanced imaging in the courtroom for concussion and TBI cases. If you need to discuss your situation with skilled brain injury attorneys proven in court, contact our law firm today.
Key Takeaways:
- Neuroradiology is a branch of radiology focused on imaging of the brain, spine, neck, and head. The more advanced scans used can provide detailed images of how the brain tissue or brain function was affected by an injury.
- Traditional CT and MRI scans of the brain may appear normal in an ER, yet a patient may have still suffered a legitimate brain injury.
- Diffusion tensor imaging (DTI) scans measure how water molecules move through brain tissue. Functional MRI (fMRI) scans measure changes in blood flow linked to brain activity. Single-photon emission computed tomography (SPECT) scans measure blood flow in the brain. Positron emission tomography (PET) scans measure brain metabolism.
- Neuroradiological imaging alone is not sufficient to prove a brain injury occurred. It’s just part of telling a client’s story that needs to be backed up by testimony from expert witnesses and an account from the brain injury survivor about their lived experience and changes in day-to-day life.
What Is Neuroradiology? How Is It Used in Traumatic Brain Injury Litigation?
Neuroradiology is a specialized branch of radiology that focuses on imaging the brain, spine, head, and neck.
In a brain injury lawsuit, neuroradiology can help link a person’s symptoms to damage or a physical injury in the brain tissue.
Neuroradiology Can Help Identify Structural and Microstructural Damage to the Brain
Without objective evidence, a brain injury case can turn into a credibility contest. The injured person describes their symptoms, and the insurer or defense argues that nothing is wrong because the scans were normal. The jury is left to decide whom to believe.
That’s where advanced neuroradiology in TBI litigation can help. Attorneys work with radiologists, neurologists, and neuropsychologists to determine whether more sensitive imaging is appropriate, helping measure blood flow and subtle damage to tissues of the brain.
This matters most when an insurer has denied or undervalued a claim by pointing to a normal ER scan.
Why Standard ER Brain Scans Miss Mild-to-Moderate TBIs
Emergency rooms rely mainly on CT (computed tomography) scans, and sometimes standard MRI (magnetic resonance imaging) scans, to rule out life-threatening problems such as bleeding, swelling, or skull fractures.
CT and MRI scans are good at detecting large structural damage. They aren’t designed to detect the microscopic injury to nerve fibers that often causes the lasting symptoms of a mild-to-moderate TBI.
Some MRI sequences, such as susceptibility-weighted imaging (SWI), are more sensitive to tiny areas of bleeding than a CT scan. But even a detailed conventional MRI can come back normal after a concussion.
Leaving the ER with Brain Injury Symptoms Despite a Normal CT or MRI Scan
Someone may leave the ER with a normal CT or MRI scan and still develop ongoing headaches, memory problems, or mood changes in the days and weeks that follow.
The brain injury is real. However, It just wasn’t visible with the tools used in an ER setting.
This mismatch is one of the most common points of dispute in brain injury claims. It’s also why advanced imaging has become part of TBI litigation.
Advanced Neuroimaging Technologies: DTI, fMRI, SPECT, and PET Scans
Several advanced imaging techniques have been studied in connection with TBI, and peer-reviewed research on them is available through the National Center for Biotechnology Information’s PubMed Central database.
Diffusion Tensor Imaging (DTI)
DTI is an MRI-based technique that measures how water molecules move through brain tissue. Because water moves in a more organized way along healthy white matter tracts, DTI can provide information about the structure and integrity of the brain’s connections.
DTI has real limitations when applied to a single patient. Changes in diffusion measurements can occur under other conditions, and results can vary with the scanner, software, and comparison data used. Current research continues to identify challenges in using DTI as a standalone diagnostic test for an individual.
Functional MRI (fMRI)
fMRI measures changes in blood flow linked to brain activity. It can be used to study the networks involved in attention, memory, and other cognitive functions.
Researchers have used fMRI in people with TBI, including to examine changes in how brain regions communicate. However, fMRI has not been established as a routine standalone diagnostic test for individual patients with TBI.
SPECT and PET
SPECT (single-photon emission computed tomography) measures blood flow in the brain, and PET (positron emission tomography) measures brain metabolism. Both have been studied as ways to detect TBI-related changes that don’t appear on CT or MRI. However, study methods vary, and researchers are still working out how to interpret the findings for an individual patient.
Are Advanced Neuroradiology Scans Admissible in Colorado Courts?
They can be.
Colorado courts evaluate this evidence under Federal Rule of Evidence 702 and People v. Shreck. Courts will consider the reliability of the science, the expert’s qualifications, and whether the testimony would help the jury.
Advanced imaging is more likely to be admitted when testing was properly performed and the findings are clearly tied to the person’s clinical symptoms. The advanced brain imaging alone should not be a standalone diagnosis.
Again, neuroradiology is part of telling your story to a jury in the most compelling, evidence-based way possible.
What Type of Brain Scan Is Best for Proving a Concussion or Mild TBI?
No single scan is best for every brain injury case.
DTI is often used to look for white matter damage, while SPECT and PET focus on blood flow and metabolic activity. Each technique has limits when used to diagnose an individual, so imaging works best alongside neuropsychological testing and clinical findings.
The right scan to use depends on the person’s symptoms, timing, and what the treating or consulting physician deems medically appropriate. This is something our trial lawyers carefully consider when assisting with a lawsuit for a mild TBI or concussion.
Connecting Neuroimaging Findings to Cognitive and Neurological Deficits
A scan becomes meaningful in a brain injury case when the findings line up with the symptoms and functional problems the person actually has.
Neuropsychological testing is often central here. It measures specific cognitive deficits that clinicians can then compare with imaging findings. This is especially important in cases involving persistent symptoms after a concussion or mild TBI.
How Do Trial Lawyers Use 3D Brain Imagery During Jury Trials?
3D renderings and other visual exhibits can help jurors understand medical findings that are hard to picture from testimony alone. The exhibit must be accurate and supported by a qualified witness before the court will allow it.
Paired with a clear explanation, these images of a person’s brain function and tissue can help a jury connect the injury to the specific symptoms the person is experiencing.
Telling Your Story to a Jury Using Scans, Symptoms, and Your Lived Experience
For example, a radiology report showing reduced blood flow in a particular brain region means little to a jury.
However, we can connect the results of that advanced brain scan with real-world impact on your day-to-day life: trouble concentrating, memory lapses, struggling to find the right words, or personality changes.
All of the evidence presented together helps explain what happened, why the symptoms are occurring, and how the injury affects your daily life in meaningful ways.
Overcoming Defense Objections to Advanced Imaging Evidence in Court
Defense attorneys and insurers frequently challenge advanced neuroimaging, and it’s worth being upfront about why.
- Disputes Over the Reliability of This Developing Technology: The science behind the use of DTI, fMRI, SPECT, and PET in individual TBI cases is still developing, and courts don’t treat this evidence as automatically admissible.
- Disputes Over the Correlation of the Imaging and Patient Symptoms: The other side may also claim the technique isn’t valid for diagnosing an individual, that the findings aren’t specific to trauma, or that the imaging wasn’t properly correlated with the person’s symptoms.
Our lawyers are trial tested, secure real results for injured victims. We understand how to push back against these kinds of arguments. The images are just part of your brain injury case.
How Expert Medical Testimony Validates Neuroradiological Scans
Because advanced imaging faces real scrutiny, the professional who interprets and testifies about the scans matters a great deal.
Expert Witnesses Can Explain the Credibility of the Technology to Juries
A qualified neuroradiologist or neurologist can explain in plain terms what the imaging shows, how the technique works, and why the findings are consistent with the person’s documented symptoms.
Professional organizations such as the American Society of Neuroradiology support research and education in the field, and a credible witness should be able to explain how their methods line up with accepted practice.
Connecting the Dots Through Imaging, Experts, and Your Day-to-Day Experiences
That testimony needs to address the reliability of the imaging method, how it was applied in this specific case, and how the results connect to your real-world limitations.
When that foundation is solid, advanced imaging can become strong supporting evidence rather than a contested exhibit.
Talk to Ogborn Mihm About Your Brain Injury Case
If you’ve been told your brain injury doesn’t show up on imaging, that doesn’t mean your symptoms aren’t real or that you don’t have a valid claim. Our team can evaluate the medical evidence, investigate how the injury happened, and work with the right medical professionals when specialized testimony is needed.
To speak with trial-proven brain injury lawyers about your case, contact our law firm today.
