Difference between revisions of "CT of the head in trauma"
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===Settings=== | ===Settings=== | ||
| − | Processed images should include thin slices in order to better evaluate any skeletal damage. | + | Processed images should include [[thin slices]] (0.5 - 1.5 mm) in order to better evaluate any skeletal damage.<ref name="MaetaniNamiki2016">{{cite journal|last1=Maetani|first1=Kazuhide|last2=Namiki|first2=Jun|last3=Matsumoto|first3=Shokei|last4=Matsunami|first4=Katsutoshi|last5=Narumi|first5=Atsushi|last6=Tsuneyoshi|first6=Toshimi|last7=Kishikawa|first7=Masanobu|title=Routine Head Computed Tomography for Patients in the Emergency Room with Trauma Requires Both Thick- and Thin-Slice Images|journal=Emergency Medicine International|volume=2016|year=2016|pages=1–4|issn=2090-2840|doi=10.1155/2016/5781790}}</ref> |
===Indications=== | ===Indications=== | ||
In adults, indications mainly include altered mental status, post-traumatic seizure, focal neurologic deficit, vomiting and/or anticoagulant medication.<ref>'''UK''': {{cite web|url=https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893|title=Head Injury - Algorithm 1: Selection of adults for CT head scan|website=NICE}} 2014</ref> There are various scoring systems for the decision ([https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893 NICE (UK)], [https://jamanetwork.com/journals/jama/fullarticle/201596 NOC (US)], [https://jamanetwork.com/journals/jama/fullarticle/201596 CCHR (Canadian)], but for the radiologist it is extremely rare to deny a CT if suggested by a clinician, since it is generally a non-contrast and relatively low dose investigation that is analysed relatively fast. | In adults, indications mainly include altered mental status, post-traumatic seizure, focal neurologic deficit, vomiting and/or anticoagulant medication.<ref>'''UK''': {{cite web|url=https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893|title=Head Injury - Algorithm 1: Selection of adults for CT head scan|website=NICE}} 2014</ref> There are various scoring systems for the decision ([https://www.nice.org.uk/guidance/cg176/resources/imaging-algorithm-pdf-498950893 NICE (UK)], [https://jamanetwork.com/journals/jama/fullarticle/201596 NOC (US)], [https://jamanetwork.com/journals/jama/fullarticle/201596 CCHR (Canadian)], but for the radiologist it is extremely rare to deny a CT if suggested by a clinician, since it is generally a non-contrast and relatively low dose investigation that is analysed relatively fast. | ||
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Revision as of 21:46, 9 January 2019
Author:
Mikael Häggström [notes 1]
Planning
Choice of modality
CT of the head in trauma, without IV contrast, is the first choice of investigation.
Settings
Processed images should include thin slices (0.5 - 1.5 mm) in order to better evaluate any skeletal damage.[1]
Indications
In adults, indications mainly include altered mental status, post-traumatic seizure, focal neurologic deficit, vomiting and/or anticoagulant medication.[2] There are various scoring systems for the decision (NICE (UK), NOC (US), CCHR (Canadian), but for the radiologist it is extremely rare to deny a CT if suggested by a clinician, since it is generally a non-contrast and relatively low dose investigation that is analysed relatively fast.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.
References
- ↑ Maetani, Kazuhide; Namiki, Jun; Matsumoto, Shokei; Matsunami, Katsutoshi; Narumi, Atsushi; Tsuneyoshi, Toshimi; Kishikawa, Masanobu (2016). "Routine Head Computed Tomography for Patients in the Emergency Room with Trauma Requires Both Thick- and Thin-Slice Images ". Emergency Medicine International 2016: 1–4. doi:. ISSN 2090-2840.
- ↑ UK: . Head Injury - Algorithm 1: Selection of adults for CT head scan. NICE. 2014
