Test your skills: Which imaging studies would you order for these neurologic complaints?

›› And you order...

…a non-contrast head CT.

For patients with symptoms suggesting acute illness such as carotid or vertebral artery dissection, order CT angiography of the head and neck.

Mr. C presents with a GCS of 15, indicating mild head trauma. However, in elderly patients, especially ones taking anticoagulation medication, even mild trauma can result in clinically significant abnormalities such as a subdural hematoma.¹ Although Mr. C’s physical and neurologic exams are not worrisome, both the NOC and CCHR recommend further evaluation with a non-contrast head CT based on his age.

CORRESPONDENCE
Urmi A. Desai, MD, MS, Columbia University Medical Center, 610 West 158th Street, New York, NY 10032; uad2101@columbia.edu.