Traumatic Brain Injury (TBI) is a significant cause of death and disability [1, 2]. It is caused by an external force such as a blow, jolt, or penetrating injury, resulting in bleeding, swelling, and damage to brain tissue. Globally, an estimated 69 million people sustain a TBI each year [3, 4]. This disparity reflects a heavier burden in low- and middle-income countries, where road traffic collisions and falls are more prevalent [5]. In the United States, there are over 25 million injury-related emergency department visits annually. According to the Centers for Disease Control and Prevention (CDC), TBIs are a major cause of death and disability nationwide with approximately 3 to 4 million new cases annually [2, 6].
Young adults aged 15 to 24 account for the highest number of emergency medicine visits related to TBI. While most TBIs are classified as mild, severe injuries can lead to prolonged unconsciousness, memory loss, seizures, and sleep disturbances [2]. The Glasgow Coma Scale (GCS) is routinely used in the initial evaluation to assess levels of consciousness (LOC) but does not provide detailed information about the injury itself. Beyond the clinical implications, the global economic impact of TBI is estimated to exceed $400 billion annually, placing a significant burden not only on the individual and family, but the healthcare systems [3, 4, 7].
Depending on the force and its effect, TBIs can range widely in severity and lasting symptoms as noted in Table 1 [2, 8]. Specifically, the GCS, duration of LOC, presence and length of post-traumatic amnesia (PTA), and imaging findings help define the classification of TBI. The majority of cases (70–90%) of TBI are considered mild and are typically limited to headaches, dizziness, confusion, and other symptoms that do not suggest permanent or long-term damage [2].
Neuroimaging techniques identify the locations and qualities of the TBI, as well as prognoses [6, 9,10,11,12,13]. Noncontrast CT is the neuroimaging scan of choice for effectively and quickly locating hemorrhages, providing context when determining severity of the injury or the need for surgical intervention. However, MRI scans, less commonly used, have proved to be more effective at locating non-hemorrhagic or micro-hemorrhagic injuries that may not be as severe at the moment.
The heterogeneity of TBI cases makes it difficult to standardize treatments at an individual level, and there is no consensus on guidelines to determine when neuroimaging is necessary for a TBI patient [14]. Neuroimaging use for TBI management is a highly debated and researched field, with rules that have been developed, such as a Canadian head CT rule, with the purpose of limiting neuroimaging for head injuries [15]. At the same, there is evidence to suggest that neuroimaging use should be increased for acute care of mild TBIs, due to its value in predicting the occurrence of post-concussion syndrome, ED readmission, and length of hospital admission [16]. This bibliometric analysis study aims to provide an overview of the research done on neuroimaging use for TBI patients from the past four decades, looking at where research is originating from, what categories comprise it, and where trends are pointing.