Difference between revisions of "CT of the head in trauma"

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===Indications===
 
===Indications===
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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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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 procedure with relatively low radiation dose and fast evaluation.
 
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Revision as of 14:08, 10 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 procedure with relatively low radiation dose and fast evaluation.

Notes

  1. ↑ 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

  1. ↑ 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:10.1155/2016/5781790. ISSN 2090-2840. 
  2. ↑ UK: . Head Injury - Algorithm 1: Selection of adults for CT head scan. NICE. 2014
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