Reading Head CTs

OK, so before I started in neurocritical care, I really didn’t know anything about reading a head CT. I’m not an expert now by any means, but I know the basics and can read an acute head CT pretty well. And, bias aside, I think this is an important skill for a critical care or emergency provider to have. Not to know all there is to know, and not to take the place of our radiology and neurology colleagues, but as a more advanced version of the CXR interpretation skill that every critical care/emergency provider needs.

Head CTs come up not all that infrequently in acute care medicine. There are the obvious examples of acute stroke or head trauma, but a non-contrast head CT is often part of the initial workup for acute mental status changes or inpatient falls. Being able to spot hemorrhages and to have an idea how bad those hemorrhages are (it’s not necessarily related to the size of the bleed) or to be able to rule in or out serious problems can be life saving.

One of my favorite sites on the Internet for all things radiology is Radiology Masterclass. A British site run by consultant radiologists, they provide excellent teaching in the essentials of radiology and offer a number of courses and tutorials. Their tutorial series on CT Brain Anatomy and Acute Brain CT are my go-to sites when I’m teaching students or new providers the fundamentals of Head CTs. They also have a number of good galleries where you can see examples of pathology and normal findings alike.