Forensic Applications of Magnetic Resonance Spectroscopy and Near-Infrared Spectroscopy in Traumatic Brain Injury: Metabolic and Hemodynamic Perspectives in Invisible Cerebral Damage
DOI:
https://doi.org/10.64784/199Keywords:
Traumatic brain injury, magnetic resonance spectroscopy, near-infrared spectroscopy, forensic medicine, diffuse axonal injury, cerebral metabolism, neuroimaging, cerebral oxygenation, invisible brain injury, neurometabolic dysfunctionAbstract
Traumatic brain injury (TBI) remains one of the leading causes of neurological disability worldwide and represents a major challenge in forensic medicine, particularly in cases involving persistent symptoms without visible structural abnormalities on conventional neuroimaging. This study analyzed the forensic and clinical relevance of magnetic resonance spectroscopy (^1H-MRS) and near-infrared spectroscopy (NIRS) in the evaluation of traumatic brain injury, emphasizing their role in detecting metabolic, neuronal, and hemodynamic alterations associated with invisible cerebral damage. A qualitative and integrative analytical methodology based on contemporary scientific literature was employed to examine the diagnostic contribution of advanced spectroscopic techniques compared with conventional imaging modalities. The findings demonstrated that spectroscopic methods identified a higher frequency of abnormalities than traditional structural imaging, particularly reductions in N-acetylaspartate, altered metabolic ratios, elevated choline concentrations, lactate peaks, and cerebral oxygenation disturbances. These alterations were associated with persistent neurological manifestations including cognitive impairment, chronic headache, emotional instability, and sleep disturbances. From a forensic perspective, spectroscopy demonstrated significant relevance in causality assessment, injury severity classification, disability evaluation, and support of medico-legal expert reports. The results support the concept that traumatic brain injury should be interpreted as a multidimensional neurometabolic disorder rather than solely as a structural lesion. Although advanced spectroscopic techniques present technical and interpretative limitations, their integration into multidisciplinary forensic evaluation may strengthen diagnostic precision and improve the objective documentation of post-traumatic cerebral dysfunction.
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