RAD CT Guide

*Assess in conjunction with Canadian CT Head Rules (RANZCR)

• Mental status change, associated with:

  • coagulopathy or anticoagulant (increased risk of haemorrhage)

  • hypertensive emergency 

  • clinical suspicion of CNS infection, mass, or elevated intracranial pressure 

  • known intracranial process including infection, mass, haemorrhage, infarct 

  • alcohol/drug use, medication related, hypoglycaemia, sepsis etc

  • persisting or worsening mental status 

• New onset delirium 

• New onset psychosis

• Ataxia post head/spinal trauma

• Ataxia without trauma 

• Transient Ischemic Attack (TIA)

• Cognitive decline, suspected dementia 

• Acute mild head trauma (GCS 13-15) with imaging indicated by clinical decision rule 

• Acute moderate head trauma (GCS 9-12), severe (GCS 3-8) or penetrating head trauma 

• Acute head trauma with unchanged neurological deficits with no initial finding on imaging

• Unchanged, or new and progressively worse neurological deficits (short term follow up imaging) with positive finding on initial imaging (subdural, ICH)

• Head trauma with suspected CSF leak 

• Headache

  • new or worsening +/- cancer history or suspected, immunodeficiency, or neurological deficit, positional, post exertion or sex, post traumatic, pregnant, papilledema

  • severe or sudden (ICH suspected)

• Seizures

  • epilepsy with change in seizure pattern or symptoms

  • first seizure, initial imaging

• Hearing loss/vertigo

• Polytrauma, blunt

• Rapidly progressive dementia

• Chorea or suspected Huntington's disease

• MND initial imaging

• Parkinson's, initial imaging

• Orbital trauma with visual defect

• Non-traumatic orbital asymmetry, non-ischaemic visual loss, diplopia or ophthalmoplegia

• Skull lesions

• Surgical indications, such as:

  • preoperative planning

  • evaluation of CSF shunt

  • postoperative evaluation post intracranial surgery