Investigating head injury (summary)

Changed by Daniel J Bell, 2 Apr 2018

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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 ¹. Causes include falls (children and the elderly), motor vehicle accidents (adults) ¹, or direct trauma from an object, assault or inflicted injuries (paediatric 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 haemorrhage 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