ABSTRACT
Computed Tomography (CT) o f the Head C T scanning has replaced m ost o ther m odalities o f im aging in the acute evalua
tion o f neurologic in ju ry or disease. N o longer are we taugh t to look for pineal gland calcification on skull film as a w ay o f detecting m id line shift, n o r do we order plain skull film s to identify skull fractures, w hen w hat we are really concerned abou t is underly ing brain injury. (A lthough there m ay still be a role for skull film s in selected cases.)
As C T technology has evolved, so has the acute trea tm en t o f m any neurologic illnesses. N eurologic injuries or illnesses are typically tim e-sensitive diagnoses, m uch as m yocardial infarction , w ith survival dependen t on tim e to trea tm ent. A good exam ple o f this is trea tm en t o f subdural hem atom a, w hose m orta lity goes from 90% to 30% if operative trea tm en t is w ith in 4 h. Rapid, available and accurate C T scan n ing is no longer the p roperty o f tertiary academ ic centers b u t now ub iqu itous th ro u g h o u t the healthcare landscape. For this reason, it is im p o rtan t for everyone to u nderstand the u tility and lim ita tions o f the technology.
