Basic head CT for intensivists.
OBJECTIVE
To present a simplified approach to computed tomography (CT) of the head to facilitate the understanding and diagnosis of common acute cerebral abnormalities in the critically ill patient.


METHODS
Published articles and texts on cerebral disorders and CT diagnosis.


RESULTS
In the unconscious and acutely ill patient a head CT is often performed to assess the possibility of an organic or 'space occupying' cerebral lesion. While specialist radiological interpretation is often available during the day, when an 'out of hours' emergency occurs the diagnosis of an intracerebral abnormality often relies upon the intensivist's interpretation of the head CT scan. With an understanding of the position and appearance of normal intracerebral structures (and artifacts) common acute cerebral disorders can be easily assessed by the non-radiologist, facilitating the correct diagnosis and the appropriate management.


CONCLUSIONS
Head CT is the commonest CT performed in the intensive care unit. In many patients who are sedated or ventilated, neurological examination is sometimes difficult and CT becomes important in clarifying patient's neurological status. A simple approach to the interpretation of brain CT images assists in the management of these cases.
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M L
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Division of Medical Imaging, Queen Elizabeth Hospital, Woodville, South Australia.