13.1

At this stage, advanced neuroimaging biomarkers are not yet ready for clinical implementation/management. 

Level of Evidence:

Biomarkers such as functional MRI (fMRI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), arterial spin labeling (ASL), cerebrovascular-reactivity mapping (CVR), quantitative susceptibility based susceptibility weighted imaging (qSWI), electroencephalography/event-related potential (EEG/ERP), transcranial magnetic stimulation (TMS), while potentially useful as research tools, are not ready for clinical implementation.

13.2

When conventional MRI is performed in the clinical management of concussion patients, the inclusion of susceptibility-weighted images (SWI) sequences could be considered as it may be useful for detecting small hemorrhages. The clinical significance of small hemorrhages on SWI is not clear at present. 

Level of Evidence:

See Recommendation 2.1c for more information on when to consider diagnostic brain or cervical spine imaging.