II. Indications

  1. Cerebrovascular Accident
    1. Differentiate Hemorrhagic CVA from Ischemic CVA
    2. More sensitive than LP for Intracranial Hemorrhage
    3. Test Sensitivity diminishes from time of Hemorrhagic CVA
      1. Test Sensitivity 95-100% at 12 hours from onset
      2. Test Sensitivity 50% at 7 days from onset
      3. Hemorrhagic CVA is not detectable on CT Head at 2-3 weeks from onset
      4. Suarez (2006) N Engl J Med 354(4): 387-96 [PubMed]
  2. Brain Tumors (larger than 2-4 mm)
    1. Enhanced with iodinated Contrast Material
  3. Hydrocephalus
    1. Temporal horn of the Lateral Ventricle dilates (axial width >=5 mm) early in Hydrocephalus
      1. Appear rounded as Hydrocephalus develops (contrast with their normal curved-slit appearance)
    2. Third Ventricle appears O-Shaped when dilated from downstream CSF obstruction
      1. Third Ventricle is normally has a more slit-like appearance
  4. Intracranial Bleeding
    1. Epidural Hematoma
    2. Subdural Hematoma
    3. Intraparenchymal Hemorrhage
    4. Subarachnoid Hemorrhage (Thunderclap Headache)
  5. Evaluation of Traumatic Head Injury
    1. CT Head in every Severe Head Injury
    2. CT Head in every Moderate Head Injury
    3. See Head Injury CT Indications
    4. See Head Injury CT Indications in Children

III. Interpretation

  1. See CT Scan Window Width
    1. Describes CT Windows for Brain Window or Subdural Window
  2. Systematic Head CT Approach Mnemonic: "Blood Can Be Very Bad"
    1. B: Blood
    2. C: Cisterns
    3. B: Brain
    4. V: Ventricles
    5. B: Bone
  3. Hemorrhage appearance on CT changes with time
    1. Acute Hemorrhage: Hyperdense (light, white)
      1. Whiter than brain matter
    2. Subacute Hemorrhage: Isodense
      1. Similar density to brain matter and may be missed
    3. Chronic Hemorrhage: Hypodense (dark)
      1. Darker than brain matter
      2. Old Subdural Hematoma may appear as a hygroma

IV. References

  1. Broder (2024) Crit Dec Emerg Med 38(7): 22-3
  2. Broder (2021) Crit Dec Emerg Med 35(5): 10-1
  3. Haydel (2000) N Engl J Med 343:100-5 [PubMed]

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Related Studies

Ontology: CAT scan of head (C0202691)

Concepts Diagnostic Procedure (T060)
ICD9 87.03
SnomedCT 408754009, 241517007, 34227000
English CT of head, CT of entire head (procedure), Computed tomography of entire head (procedure), Computed tomography of entire head, CT scan of head, head CT scan, computed tomography of head (procedure), computed tomography of head, ct head, head ct, head ct scan, cat scan head, ct of head, ct scan of head, cat head scan, ct head scans, ct scan head, head cat scan, cat scan of head, ct head scan, cat head scans, CT of head (procedure), CT of entire head, Head CT, Computerized axial tomography of head, Computerized tomography of head, Computerised axial tomography of head, Computerised tomography of head, CAT scan of head, C.A.T. scan of head, CT scan;head, CT scan of the head
Spanish tomografía computarizada de la cabeza completa (procedimiento), tomografía computarizada de la cabeza completa, TC de la cabeza completa, TC de todo el cráneo (procedimiento), TC de todo el cráneo, tomografía computarizada de cabeza, tomografía computarizada de cabeza (procedimiento), tomografía axial computarizada de la cabeza, tomografía computarizada de la cabeza