CT is the primary neuroimaging technique in the acute evaluation of the head trauma patient.
CT (also called CAT Scan) imaging uses a computer to digitally create an image based upon absorption of X-rays through the brain.
Detectors positioned around the head collect readings from multiple angles. The scanner then reconstructs an image of each slice.
Pros:
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- The CT scan is fast, making it preferable to MRI for acute cases as surgical intervention decisions must be made quickly.
- CT is available in almost all hospitals.
- CT can be done without removing the patient from IVs or other ICU equipment. In contrast metal devices must be removed before the patient is exposed to the MRI magnet.
- CT does a good job of identifying brain bleeds and the effect of swelling.
- CT, as it uses X-ray, is better at seeing most fractures than MRI and because of its computerized analysis, superior to X-ray.
- CT is more sensitive to most life threatening conditions than other imaging techniques in the first 72 hours.
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Contra:
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- CT scans are a structural test and do not see axonal injury, except in the most extreme cases.
- CT has poorer resolution than MRI.
- CT scans have little post acute value after swelling has gone and the blood from bleeds have been reabsorbed.
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