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Forum Name: Neurology Topics

Question: CT scan without contrast done on brain.


 nxp21 - Sat Jul 31, 2010 1:04 pm

Hi, I hit my left back side of head with a small closet while turning. there wasn't any harsh pain or bleeding. But a little scratch on skin of head of that part. Then I went to doctor to get it checked if there is any concern. she ordered CT Scan. I did it but it was without contrast. as i ate before that scan.
The report says nothing is abnormal in side the head.
but doctor told me if I feet dizziness or vomiting, I have to go to hospital.

* I don't feel vomiting or dizzyness.
* I am feeling discomfort in eyes while working on computer
* dryness in eyes and little pain where i hit my head which draw my attention to it.
* and yes after sleeping whole night still the eyes don't feel 100 % smoothness I have to use the eye drops.


My concern is that the discomfort in eyes is because of the stroke in head ?
is any thing can be serious with my brain ?
And do I need to do another CT Scan with contrast ?
or it will go away gradually ?
 Dr.M.Aroon kamath - Tue Aug 10, 2010 12:47 am

User avatar Hi,
I will provide you with some basic information on the use of CT scans in the emergency situations, so as to enable you to comprehend this better.

There is hardly any dispute concerning use of contrast in the context of "vascular CT" but, controversy does exist in respect of "non-vascular CT".

One study observed thus: "Decisions regarding the use of contrast agents usually arise in the context of nonvascular CT. Although highly desirable in many situations, contrast enhancement is not absolutely required for nonvascular CT and may not add much to the emergency department evaluation in many situations. While the potential imaging benefits versus the risks of contrast-enhanced CT always should be discussed with a radiologist on a case-by-case basis".
( http://www.accessmedicine.com/content.aspx?aID=614948 )

Another study concluded thus: "it is reasonable not to give contrast if there is a low expectation of a lesion being present, and if the unenhanced scan is normal".
( http://www3.interscience.wiley.com/jour ... 1&SRETRY=0 )

Studies in the pediatric population also indicate similar trends such as in the adults.
One such study draws the following conclusion: "Unenhanced CT of developing brains has high sensitivity and specificity in the diagnosis of pathologic findings. The use of intravenous contrast material after unenhanced CT of the brain in children did not change the diagnosis frequently".
( http://radiology.rsna.org/content/244/3/838.full )

Protocols may vary from place to place and from one institution to another but, the decision whether to use contrast or not is
- either left up to the discretion of the imaging physician or
- in others, the treating clinician & radiologist may discuss and come to a consensus opinion.


Your doctor obviously felt that contrast was not needed (in a rather acute setting), which it is entirely acceptable.Rather than you deciding about the need for contrast or otherwise, you should leave it to your doctor who, after examining you neurologically, will be able to arrive at a decision regarding this.
Best wishes!

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