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Head CT scan (without contrast)

A head CT without contrast is the scan that answers urgent questions: is there bleeding inside the skull, is there a fracture, is the brain swelling or shifted. It takes a few minutes, needs no injection, and is the reason most emergency departments have a scanner.

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What it is

Fresh blood is dense, and bone is denser still, and CT is very good at telling dense things from soft ones. That is the whole basis of this scan. Without any injected dye, a head CT separates bleeding from brain tissue, shows the shape and position of the ventricles, and renders the skull clearly enough to find a fracture. Contrast is not used here because it adds nothing to those particular questions and would only delay an answer that is often needed in minutes. What the scan is comparatively poor at is subtle brain tissue change, which is MRI territory.

Why it is done

  • To look for bleeding inside the skull or a skull fracture after a head injury
  • To distinguish a bleed from a blocked vessel in someone with sudden stroke symptoms, which changes the treatment immediately
  • To investigate a sudden severe headache, new confusion, seizures or persistent dizziness
  • To check for fluid buildup in the ventricles, or to recheck a known finding after treatment

What to expect

Patients lie on their back on a table that slides into the ring of the scanner, head resting in a cradle, and are asked to stay still. The imaging itself is over in seconds to a couple of minutes. There is no injection and no preparation for the plain study, so someone arriving from an emergency department can be scanned almost immediately. The images go to a radiologist who writes a report for the ordering clinician; in an emergency the critical findings are usually phoned through well before the written report exists.

Questions worth asking

  • Will there be two bills for this scan, one from the hospital for the scanner and one from the radiologist for reading it?
  • Is the radiologist group in network? Radiologists who read for a hospital often contract separately, and patients rarely choose them.
  • If this was done during an emergency department visit, is the scan included in the visit level or itemized on its own?
  • If a follow-up scan is planned, can it be scheduled at an outpatient imaging center instead, and what is the price difference?

What Head CT scan (without contrast) costs by state

Head CT scan (without contrast) prices at hospitals

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