Can a CAT scan detect signs of an unruptured aneurysm?
I went to urgent care about a week and partly ago due to a bad one sided headache, light sensitivity, eye pressure, neck stiffness etc. They sent me to the ER to own a CAT scan. It was without contrast.
It was mundane and the ER doctor said probably a migraine but if it didn't go away to go have an MRI.
My doctor didn't mention an MRI. He give me migraine meds and did some blood work, dilated eye exam. All was normal, I did need specs however.
I am under the care of my doctor and I trust his judgement. However, this is a question I didn't devise to ask him. Is a CAT scan normally the first step to finding serious causes of head aching? Would the CAT scan reveal signs of an unruptured aneurysm? I've been reading up online about it but all the medical idiolect is confusing.
Any help is greatly appreciated!
Answers:
CT is generally the first port of call because it is cheap, around, and is able to rule out causes of headache requiring immediate treatment, including hydrocephalus, subarachnoid haemorrhage, TIA (transient ischaemic attack) and ruptured aneurysm. The ER doctor would first want to rule out any of these - an unruptured aneurysm is unlikely to motive a sudden, severe headache, and can go unnoticed for a long time without causing any trouble.
MRI is habitually only available in specialist centres, is relatively expensive, and, if you go to the ER out of hours, the staff required to operate it are often 'on call' rather than in the hospital. As an example, I work contained by a country hospital with a CT scanner - the nearest MRI is 100km away, and they don't offer an on-call service.
You're right in that contrast is indicated for requests that are query unruptured aneurysms, metastases, pituitary lesions and a past history of brain tumours. It may be given where the request is query a space occupying lesion or brain tumour. It is not generally given in trauma/ER situations because it is surplus to requirements to rule out the conditions I listed above - in fact, a topical 'bleed' resembles contrast, as it is high i iron and looks white on a CT, just like iodine.
The broad practice is that, unless contrast is indicated as in the list above, non-contrast scans are done, and consequently, if any abnormality is seen, contrast is given and further scans are done under the instruction of the radiologist.
Contrast is not given if you are allergic to iodine. It should be reconsider if you are asthmatic, diabetic (and on Metformin), have heart disease, have kidney disease or impaired renal function. Risks of iodinated contrast include anaphylaxis and renal end.
If you are still worried about your headaches, it is not unreasonable to have an angiogram of your boss (or, as the vessels are called, Circle of Willis). This can be done with any MRI or CT (note that a CT angiogram is different to a CT Brain with contrast - from your point of view, the exams the same, but the descriptions are acquired slightly differently). One isn't particularly better than the other - MRI has slightly better resolution, but is more expensive and not as close at hand. CT will still give an accurate result, and is cheaper and easy to access. Different contrast agents are used - CT uses iodine (aka Ultravist or Omnipaque) and MRI uses gadolinium.
If you have any other question, please check with your referring doctor or the radiographer doing your scan - we're there to help! Source(s): I'm a CT radiographer.
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It was mundane and the ER doctor said probably a migraine but if it didn't go away to go have an MRI.
My doctor didn't mention an MRI. He give me migraine meds and did some blood work, dilated eye exam. All was normal, I did need specs however.
I am under the care of my doctor and I trust his judgement. However, this is a question I didn't devise to ask him. Is a CAT scan normally the first step to finding serious causes of head aching? Would the CAT scan reveal signs of an unruptured aneurysm? I've been reading up online about it but all the medical idiolect is confusing.
Any help is greatly appreciated!
Answers:
CT is generally the first port of call because it is cheap, around, and is able to rule out causes of headache requiring immediate treatment, including hydrocephalus, subarachnoid haemorrhage, TIA (transient ischaemic attack) and ruptured aneurysm. The ER doctor would first want to rule out any of these - an unruptured aneurysm is unlikely to motive a sudden, severe headache, and can go unnoticed for a long time without causing any trouble.
MRI is habitually only available in specialist centres, is relatively expensive, and, if you go to the ER out of hours, the staff required to operate it are often 'on call' rather than in the hospital. As an example, I work contained by a country hospital with a CT scanner - the nearest MRI is 100km away, and they don't offer an on-call service.
You're right in that contrast is indicated for requests that are query unruptured aneurysms, metastases, pituitary lesions and a past history of brain tumours. It may be given where the request is query a space occupying lesion or brain tumour. It is not generally given in trauma/ER situations because it is surplus to requirements to rule out the conditions I listed above - in fact, a topical 'bleed' resembles contrast, as it is high i iron and looks white on a CT, just like iodine.
The broad practice is that, unless contrast is indicated as in the list above, non-contrast scans are done, and consequently, if any abnormality is seen, contrast is given and further scans are done under the instruction of the radiologist.
Contrast is not given if you are allergic to iodine. It should be reconsider if you are asthmatic, diabetic (and on Metformin), have heart disease, have kidney disease or impaired renal function. Risks of iodinated contrast include anaphylaxis and renal end.
If you are still worried about your headaches, it is not unreasonable to have an angiogram of your boss (or, as the vessels are called, Circle of Willis). This can be done with any MRI or CT (note that a CT angiogram is different to a CT Brain with contrast - from your point of view, the exams the same, but the descriptions are acquired slightly differently). One isn't particularly better than the other - MRI has slightly better resolution, but is more expensive and not as close at hand. CT will still give an accurate result, and is cheaper and easy to access. Different contrast agents are used - CT uses iodine (aka Ultravist or Omnipaque) and MRI uses gadolinium.
If you have any other question, please check with your referring doctor or the radiographer doing your scan - we're there to help! Source(s): I'm a CT radiographer.
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