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Cranial CT scan
Definition
A cranial computed tomography (CT) scan uses many x-rays to create pictures of the head, including the skull, brain, eye sockets, and sinuses.
See: Computed tomography
Alternative Names
Brain CT; Head CT; CT scan - skull; CT scan - head; CT scan - orbits; CT scan - sinuses; Computed tomography - cranial
How the Test is Performed
You will be asked to lie on a narrow table that slides into the center of the CT scanner.
Once you are inside the scanner, the machine's x-ray beam rotates around you. (Modern "spiral" scanners can perform the exam without stopping.)
A computer creates separate images of the body area, called slices. These images can be stored, viewed on a monitor, or printed on film. Three-dimensional models of the head area can be created by stacking the slices together.
You must be still during the exam, because movement causes blurred images. You may be told to hold your breath for short periods of time.
Generally, complete scans take only a few minutes. The newest scanners can image your entire body, head to toe, in less than 30 seconds.
How to Prepare for the Test
Certain exams require a special dye, called contrast, to be delivered into the body before the test starts. Contrast helps certain areas show up better on the x-rays.
- Contrast can be given through a vein (IV) in your hand or forearm. If contrast is used, you may also be asked not to eat or drink anything for 4-6 hours before the test.
- Let your doctor know if you have ever had a reaction to contrast. You may need to take medications before the test in order to safely receive this substance.
- Before receiving the contrast, tell your health care provider if you take the diabetes medication metformin (Glucophage) because you may need to take extra precautions.
If you weigh more than 300 pounds, find out if the CT machine has a weight limit. Too much weight can cause damage to the scanner's working parts.
You will be asked to remove jewelry and wear a hospital gown during the study.
How the Test Will Feel
The x-rays produced by the CT scan are painless. Some people may have discomfort from lying on the hard table.
Contrast given through a vein may cause a slight burning sensation, a metallic taste in the mouth, and a warm flushing of the body. These sensations are normal and usually go away within a few seconds.
Why the Test is Performed
A cranial CT scan is recommended to help diagnose or monitor the following conditions:
- Birth (congenital) defect of the head or brain
- Brain infection
- Brain tumor
- Buildup of fluid inside the skull (hydrocephalus)
- Craniosynostosis
- Injury (trauma) to the head and face
- Stroke or bleeding in the brain
A cranial CT may also be done to look for the cause of:
- Changes in thinking or behavior
- Fainting
- Headache, when certain other signs or symptoms are present
- Hearing loss (in some patients)
- Symptoms of damage to part of the brain, such as vision problems, muscle weakness, numbness and tingling, hearing loss, speaking difficulties, or swallowing problems
What Abnormal Results Mean
Abnormal results may be due to:
- Abnormal blood vessels (arteriovenous malformation)
- Aneurysm in the brain
- Bleeding (for example, chronic subdural hematoma or intracranial hemorrhage)
- Bone infection
- Brain abscess or infection
- Brain damage due to injury
- Brain tissue swelling or injury
- Brain tumor or other growth (mass)
- Cerebral atrophy (loss of brain tissue)
- Hydrocephalus (fluid collecting in the skull)
- Problems with the hearing nerve
- Stroke or transient ischemic attack (TIA)
Risks
Risks of CT scans include:
- Being exposed to radiation
- Allergic reaction to contrast dye
CT scans do expose you to more radiation than regular x-rays. Having many x-rays or CT scans over time may increase your risk for cancer. However, the risk from any one scan is small. You and your doctor should weigh this risk against the benefits of getting a correct diagnosis for a medical problem.
Some people have allergies to contrast dye. Let your doctor know if you have ever had an allergic reaction to injected contrast dye.
- The most common type of contrast given into a vein contains iodine. If a person with an iodine allergy is given this type of contrast, nausea or vomiting,sneezing, itching,or hives may occur.
- If you absolutely must be given such contrast, your doctor may give you antihistamines (such as Benadryl) or steroids before the test.
- The kidneys help remove iodine out of the body. Those with kidney disease or diabetes may need to receive extra fluids after the test to help flush the iodine out of the body.
Rarely, the dye may cause a life-threatening allergic response called anaphylaxis. If you have any trouble breathing during the test, you should notify the scanner operator immediately. Scanners come with an intercom and speakers, so the operator can hear you at all times.
Considerations
A CT scan can reduce or avoid the need for invasive procedures to diagnose problems in the skull. This is one of the safest ways to study the head and neck.
Other tests that may be done instead of Cranial CT scan include:
- MRI of the head
- Positron emission tomography (PET) scan of the head
- Skull x-ray
References
Shaw AS, Dixon AK. Multidetector computed tomography. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 4.
Saunders D, Jäger HR, Murray AD, Stevens JM. Skull and brain: methods of examination and anatomy. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 55.
Reviewed By: Ken Levin, MD, Private Practice specializing in Radiology and Nuclear Medicine, Allentown, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
