CT is highly sensitive for the detection of findings that may require neurosurgical intervention (eg, new or worsening hemorrhage, herniation, and hydrocephalus). Multiplanar reformatted images have been shown to increase diagnostic accuracy and should be included [16,17]. In patients with a positive initial CT, reported predictors of imaging progression include subfrontal/temporal parenchymal contusion, volume of ICH >10 mL, use of anticoagulation, and >65 years of age [42]. In patients with a negative initial CT, delayed ICH is a rare but possible complication (overall incidence <0.5%) [35]. CTA Head and Neck There is no relevant literature to support the use of CTA in the short-term follow-up imaging evaluation of acute head trauma without suspected vascular injury (see Variants 8 and 9 when suspected). FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the short-term follow-up imaging evaluation of acute head trauma. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of SPECT in the short-term follow-up imaging evaluation of acute head trauma. MR Spectroscopy Head There is no relevant literature to support the use of MRS in the short-term follow-up imaging evaluation of acute head trauma. MRA Head and Neck There is no relevant literature to support the use of MRA in the short-term follow-up imaging evaluation of acute head trauma. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI in the short-term follow-up imaging evaluation of acute head trauma. MRI Head Head CT is the most useful follow-up imaging modality for the evaluation of any trauma patient with neurologic deterioration, especially in the acute setting, and regardless of whether the initial imaging was positive or negative [2]. Brain MRI may be indicated as a second-line study when there are persistent neurologic deficits that remain unexplained after the head CT.
Head Trauma PCAs. CT is highly sensitive for the detection of findings that may require neurosurgical intervention (eg, new or worsening hemorrhage, herniation, and hydrocephalus). Multiplanar reformatted images have been shown to increase diagnostic accuracy and should be included [16,17]. In patients with a positive initial CT, reported predictors of imaging progression include subfrontal/temporal parenchymal contusion, volume of ICH >10 mL, use of anticoagulation, and >65 years of age [42]. In patients with a negative initial CT, delayed ICH is a rare but possible complication (overall incidence <0.5%) [35]. CTA Head and Neck There is no relevant literature to support the use of CTA in the short-term follow-up imaging evaluation of acute head trauma without suspected vascular injury (see Variants 8 and 9 when suspected). FDG-PET/CT Brain There is no relevant literature to support the use of FDG-PET/CT in the short-term follow-up imaging evaluation of acute head trauma. HMPAO SPECT or SPECT/CT Brain There is no relevant literature to support the use of SPECT in the short-term follow-up imaging evaluation of acute head trauma. MR Spectroscopy Head There is no relevant literature to support the use of MRS in the short-term follow-up imaging evaluation of acute head trauma. MRA Head and Neck There is no relevant literature to support the use of MRA in the short-term follow-up imaging evaluation of acute head trauma. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI in the short-term follow-up imaging evaluation of acute head trauma. MRI Head Head CT is the most useful follow-up imaging modality for the evaluation of any trauma patient with neurologic deterioration, especially in the acute setting, and regardless of whether the initial imaging was positive or negative [2]. Brain MRI may be indicated as a second-line study when there are persistent neurologic deficits that remain unexplained after the head CT.