COMPUTED TOMOGRAPHY (CT SCAN)

CT scan was initially introduced for the use in clinical diagnosis by

House field in England in 1972. Now it represents the cornerstone of neurological diagnostic
procedures. This technological advance has been accepted for its accuracy safety and
versatility for use in all body syste!s.
"uring the CT scan the head is scanned in successive layers by narrow #$ rays bea!s that
pass through head and are absorbed ad trans!itted depending on the density of the tissue.
The thic%ness of a scanner layer called a slice can vary fro! 1.& to 1'!!. (lices are ta%en at
a slightly angled hori)ontal plane. *ecant spiral scanners can reconstruct i!ages even at '.+
!!.
The radiation trans!itted fro! the tissue is detected by array of scintillation crystals
,scanner- that converts the trans!itted #$ rays ,radiations- into light photons in proportion to
the energy and intensity of the trans!itted radiation. The photons are inturn converted to
electrical signals that are digiti)ed and the infor!ation can be !anipulated by speciali)ed
co!puters progra!s to reproduce i!ages representing the various slices of the craniu! .
brain in various orientations. ,coronal sagittal hori)ontal- on a display !onitor. The display
i!age !ay be photographed with standard #$ ray or /olaroid fil!.
The digiti)ed conversion of the i!ages results in anato!ical visuali)ation which correlates to
tissue density. The denser structure.

PROCEDURE
The patient lies on an 0 1 ray table with face uncovered and head i!!obilised. 2
!ovable circular fra!e encircles the head and revolves around it !a%ing a cla%ing sound
while ta%ing radiographic readings. The head is scanned nu!erous ti!es at different angles.
3f contrast !ediu! is in4ected to enhance certain areas the additional pictures are ta%en after
a short delay. The entire procedure lasts for 1& to 5' !inutes and the patient has to re!ain
!otionless as !ove!ent can cause articrafts within the i!age that will affect the clarity of
the picture. However a spiral scanner can perfor! the entire e0a!ination in less than a
!inute and thus can be used to scan uncooperative patients.
INDICATIONS
a. CT scan is e0tre!ely useful in localising and diagnosing various cranial lesions such as
abscesses cysts infarctions he!ato!as contusions hydrocephalus and pri!ary and
secondary !etastatic tu!ors.
b. to identify ventricular si)e.
ADVANTAGES
3t is a painless and safe procedure
6uch infor!ation can be collected when a proble! is still in its early stages.
Cost is relatively reasonable and drastically reduces the need for !ore invasive diagnostic
tests such as cerebral angiogra!.
3t can be perfor!ed on both conscious and unconscious patients
*adiation e0posure is relatively low co!pared to that of s%ull fil!s.
(erial CT scans can be ta%en to follow the resolutions of cerebral disorders ,hae!orrhage
oede!a etc.-
DISADVANTAGES
3t has decreased sensitivity in detecting lesion ad4acent to bone soft tissue lesions
7ses radiation
NURSES RESPONSIBILITY
2 nurse should give a general e0planation of the procedure and e8uip!ent used to
prepare the patient psychologically.
Consent to be ta%en and patients should be told that they !ust re!ain very still while
the scan is being ta%en to ensure accuracy and 8uality graphs.
2ll 4ewellery eye glasses and !etal ob4ects shall be re!oved fro! the head.
No dietary restrictions if contrast is not given.
3f contrast is planned9
o :eep the patient nothing per !outh for ;$& hours before the test.
o <ind out if patient is asth!atic or is allergic to any drugs.
<or children and restless patients sedation !ay be given
<or so!e children or adults who are not cooperating or having involuntary
!ove!ents CT !ay be done under general anaesthesia.
DURING PROCEDURE
o =efore radiopa8ue contrast !ediu! is ad!inistered a s%in tests to be done to chec%
for allergic reactions.
o >hile giving contrast patient is as%ed to ta%e deep breathing till th e in4ection is
co!pleted.
POST PROCEDURE
?bserve the patient who received contrast !ediu! for delayed allergic reaction such
as hives s%in rashes itching nausea headache swelling of face breathlessness.
3f sy!pto!s are severe antihista!ines and hydrocortisone !ay be given as per the
hospital policy.
/atient should be hydrated to clear contrast fro! te body faster
/atient who had CT under general anesthesia is %ept on 3@ fluids and nothing per
!outh for a few hours.