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CT scan or not

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I fell from a two-wheeler two days ago, hit my head and sustained a cut injury on my forehead. There is mild headache also. Should I get a CT scan done?
When a person suffers a blow to the head the concern is whether there is injury to the brain or not. The best investigation for this purpose, if a head injury is suspected, is a CT scan of the brain. It is useful in determining if a person has internal bleeding in the brain or a fracture of the skull and also helps in deciding if the person requires surgery.  However, one has to exercise caution. A CT scan uses X-rays that penetrate the body at various angles to give a picture of  the internal structure of the body. X-rays are a form of ionising radiation, that is, they have a tendency to cause cancers especially in high doses. The harm due to radiation from a chest x-ray or arm x-ray is negligible due to the low doses used. The dose of radiation from a CT scan of the head is about 20 - 150 times that of a chest or arm x-ray. For an adult, the risk of radiation damage is still low but caution must be exercised especially for children and pregnant mothers.
So, should a CT scan of the head be done at all ? The answer is yes, if a head injury, that is, injury to the brain, is suspected.  A head injury is suspected following a blow to the head if there are the following symptoms - loss of consciousness or altered consciousness, repeated vomiting, severe headache, seizures (fits), or bleeding or watery discharge from the ear, nose or mouth. Children especially, present with repeated episodes of vomiting or seizures. In such cases, the benefits of doing a CT scan far outweigh the slight risk. A mild headache, giddiness,  or scratches or cuts to the head, on the other hand, do not necessarily indicate a head injury and a CT scan does not offer much benefit. It is just not worthwhile taking a CT scan “just to see” if everything is alright, keeping in mind the risk, however small it may be.
Dr Tony Abraham
Department of Neurosurgery
CIHSR
For queries related to any health issues, please email us at askdoctor@cihsr.in or sms to 8974036093

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