画像診断

Diagnostic Neuroradiology in Head Injury

Point

・急性期頭部外傷における初期診療で第一選択とする画像診断法は単純頭部CTである．

・初回CTでは，緊急開頭術が必要な頭蓋内出血の有無を評価する．

・二次性損傷を評価するためrepeat CTを行う．

・軽傷頭部外傷では，放射線被曝を考慮して神経学的随伴症状などを確認してCTの適応を決める．

　The 4th edition of the Guidelines for Treatment and Management of Head Injury by the Japan Society of Neurotraumatology newly published a three-step evaluation method for CT, indications for repeat CT, cancer risk associated with radiation exposure, and preparation of examination guidelines for reduction of radiation exposure. This manuscript describes how to proceed with diagnostic imaging of head injuries and the new items.

　The important points are as follows:

　・CT is the first-step diagnostic imaging method in the acute phase.

　・Initial CT assesses the presence or absence of intracranial hemorrhage requiring emergency craniotomy.

　・It is necessary to perform repeat CT to assess secondary injury.

　・For minor head injuries, the indication for CT should be determined by confirming neurological concomitant symptoms considering radiation exposure.