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Brain CT

Brain CT — first-line imaging in emergency departments for stroke, head trauma and intracranial hemorrhage assessment.

Rapid imaging of brain tissue, the skull and blood with computed tomography. Provides results within minutes in acute neurological conditions.

Indication

  • Sudden-onset headache, altered consciousness, speech or motor loss (suspected stroke)
  • Evaluation of bleeding or bone fracture after head trauma
  • Suspected subarachnoid hemorrhage or intracerebral hemorrhage
  • Follow-up of hydrocephalus (cerebrospinal fluid circulation disorder)
  • Pre- or post-operative monitoring
  • Rapid scanning when MRI is not suitable (pacemaker, metallic implant)
  • New-onset seizure (suspected epilepsy)

Preparation

  • Special preparation is generally not required for non-contrast scans
  • If a contrast study is planned, fasting for 4 hours beforehand is needed
  • Known iodine allergy and metformin use should be reported
  • No metal accessories, hairpins or dentures should be worn

How it's performed

  1. The patient lies on their back with the head placed in a stabilizing support
  2. Remaining still for a few seconds is sufficient
  3. The scanner rotates rapidly and acquires brain cross-sections within seconds
  4. If contrast is needed, it is administered through an IV line
  5. The procedure is painless and the noise level is acceptable

Post-procedure

  • No specific restrictions are required after the procedure
  • If contrast was administered, drinking plenty of water that day is recommended
  • In emergencies, images are interpreted by a radiologist or neurology team within minutes
  • The result guides the follow-up plan based on treatment decisions

Risks

  • CT involves ionizing radiation; brain CT corresponds to approximately 1-2 mSv (about 6-12 months of natural background radiation)
  • In children and young patients, it is not repeated unless necessary
  • Allergic reactions to iodinated contrast may rarely occur
  • Contrast risk should be assessed in patients with kidney impairment
  • During pregnancy, it is performed only in emergencies

FAQ

Is brain CT or MRI better?

CT is preferred for acute hemorrhage, head trauma and rapid scanning. MRI is superior for soft tissue, white matter diseases, small stroke foci, and conditions such as MS. The choice depends on the clinical question.

How long does the scan take?

A standard non-contrast brain CT is completed within 1-2 minutes. The total time including preparation is 5-10 minutes.

Why is CT performed first when stroke is suspected?

Due to its speed and clear demonstration of hemorrhage, CT is the first-line method in stroke management, especially when deciding on thrombolytic therapy.

Do I have to stay in a closed tunnel during the scan?

No. The CT scanner is ring-shaped; only the head is in the scanning area, and most of the body remains open. It is more comfortable than MRI in terms of claustrophobia.

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