CAMRT Radiography Practice Exam

A trauma patient has a CT scan for their head and an enhanced Chest, Abdomen, Pelvis. Why is the head done first?

1. The CT machine is better at imaging the head

2. Contrast appears white and could be mistaken for a fresh brain bleed

3. Head scans typically take longer

4. To prioritize the most critical area

The correct answer is: Contrast appears white and could be mistaken for a fresh brain bleed

The rationale for performing the head CT scan first is primarily concerned with the interpretation of imaging results in the context of trauma. When enhanced imaging is performed for the chest, abdomen, and pelvis, the use of contrast material is common to delineate vascular structures and organs clearly. However, when interpreting a head CT, fresh brain bleeds appear hyperdense (white) on enhanced scans, similar to the appearance of contrast agents. If the chest, abdomen, and pelvis scans with contrast were conducted first, any potential intracranial bleeding could be obscured or misinterpreted, leading to significant clinical consequences. By prioritizing the head scan prior to the contrast-enhanced studies, clinicians can accurately assess for any acute intracranial injuries such as hemorrhages without the interference of contrast material. Recognizing the presence of bleeding early is crucial for timely intervention in trauma cases, making this approach vital for patient care.