CT or CAT Scan
CT or CAT scanning is the primary neuroimaging technique in the initial evaluation of the acute head trauma patient.
CT imaging uses a computer to digitally construct an image based upon the measurement of the absorption of X-rays through the brain.
Detectors positioned around the circumference of the scanner collect attenuation readings from multiple angles. A computerized algorithm reconstructs an image of each slice.
Pros:
- CT is fast, which makes it preferable to MRI for acute cases.
- CT is available in almost all acute care facilities.
- CT can be administered while the patient is hooked up to IVs or other ICU equipment.
- CT does a good job of identifying intracranial bleeding/mass effect.
- CT is best for fractures, superior to X-ray.
- CT is more sensitive to certain life threatening conditions than MRI in the first 72 hours.
- It can be done with and without contrast.
Contra:
- CT is a structural test.
- CT has poorer resolution.
- CT has little post acute value.
Understanding Subtle Brain Injury
The concussions that disable, are almost always more symptomatic at 24 hours, than at the 2-4 hour time frame when injured persons are evaluated in the emergency room. Brain injury symptoms escalate over the first 24 hours, because brain injury involves a cascade of events. It is critical that if you are still symptomatic the day after your injury, go back to the same Emergency Room, don’t wait for a doctors appointment. It is critical that the Emergency Room personnel see that the symptoms still persist or have gotten worse.
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