Interpreting head computed tomography scans
Familiarity with certain cross sectional “cuts” will simplify interpretation
- By: Adam Marcus, Hani Marcus, Ramez Kirollos
Computed tomography (CT) scans of the head are investigations that are commonly requested, particularly when an acute brain injury such as trauma or stroke is suspected. Junior doctors often find interpreting CT scans of the head daunting. The complex anatomy of the brain might be unfamiliar, making it difficult to recognise and localise lesions confidently. In this article we review normal brain anatomy, describe a systematic approach to reviewing scans, and illustrate important and commonly encountered pathologies.
CT scans are available in most hospitals but are quite expensive investigations and carry a high dose of ionising radiation. The use of these scans must therefore be clinically justified—that is, a result (positive or negative) will aid diagnosis or alter the management of a patient. The UK Royal College of Radiologists publishes regular guidelines on the indications for CT head scans (box 1), and most radiology departments encourage doctors to discuss equivocal