Which imaging study is most appropriate first imaging study for suspected head injury?

Which imaging study is most appropriate first imaging study for suspected head injury?

• A. Lumbar puncture
• B. MRI
• C. CT scan
• D. EEG

Answer: (C)

In suspected head injury, you need a fast, reliable screen to detect acute intracranial bleeding or mass effect that will guide urgent management. A CT scan of the head without contrast provides that quickly: it is widely available, can be performed rapidly, and is highly effective at detecting acute hemorrhage, skull fractures, edema, and shifts in brain structures—information critical for deciding on interventions. Lumbar puncture isn’t an imaging test and could be dangerous if there’s increased intracranial pressure or a mass lesion, as it might cause herniation. EEG measures brain electrical activity and won’t reveal structural injuries like bleeding or fractures. MRI offers more detail for certain injuries but takes longer, is less accessible in many emergency settings, and isn’t ideal for initial assessment in acute trauma. Therefore, the best first imaging study is the CT scan of the head without contrast.

In suspected head injury, you need a fast, reliable screen to detect acute intracranial bleeding or mass effect that will guide urgent management. A CT scan of the head without contrast provides that quickly: it is widely available, can be performed rapidly, and is highly effective at detecting acute hemorrhage, skull fractures, edema, and shifts in brain structures—information critical for deciding on interventions.

Lumbar puncture isn’t an imaging test and could be dangerous if there’s increased intracranial pressure or a mass lesion, as it might cause herniation. EEG measures brain electrical activity and won’t reveal structural injuries like bleeding or fractures. MRI offers more detail for certain injuries but takes longer, is less accessible in many emergency settings, and isn’t ideal for initial assessment in acute trauma. Therefore, the best first imaging study is the CT scan of the head without contrast.