Investigating head injury (summary)

This is a basic article for medical students and other non-radiologists

Investigating head injury is frequently required because head injury is common: in the US there are 1.3 million traumatic brain injuries per year . Causes include falls (children and the elderly), motor vehicle accidents (adults) , or direct trauma from an object, assault or inflicted injuries (pediatric patients).

Reference article

This is a summary article; read more in our article on traumatic brain injury.

Summary

• questions
  • what was the mechanism of injury?
  • what was the GCS and what is it now?
  • has the patient been unconscious?
  • is the patient protecting their airway?
  • is the patient safe to leave their current environment?
• investigations
  • CT head
    • most useful investigation
    • non-contrast examination from skull vertex to palate
    • usually performed as a volume allowing reconstruction
    • particularly useful for hemorrhage and fractures
  • MRI
    • occasionally used
    • useful in patients who are not waking up
• making the request
  • does a CT need to be done?
    • NICE guidance, Canadian CT head rules
  • does it need to be done urgently?
    • why?
  • is the patient safe to come to CT?
• common pathology
  • skull fractures
  • extradural hemorrhage
  • subdural hemorrhage
  • subarachnoid hemorrhage

Teaching playlist

• head injury playlist