Should You Get a CT Scan After a Head Injury? A Guide for Seniors

Q: Should You Get a CT Scan After a Head Injury? A Guide for Seniors

Hello： In cases of head trauma, the most rapid changes occur within the first three days. <br>From January 30th to now, it has been a week, and the risk has significantly decreased. <br>However, in elderly individuals over 60, there is a small possibility of chronic subdural hema

Head injury

Hello doctor, I would like to ask about my mother, who is 63 years old.
On the evening of January 30th, she bumped her head against the upper refrigerator door while wiping off the water from the fridge.
It made a "thud" sound, and she felt pain for a moment, but then she was fine.
The next day, she did not experience any dizziness or nausea, and now, five days later, she still has no symptoms.
I would like to know if I should take my mother to the hospital for a CT scan, as I am concerned about the possibility of chronic bleeding.
Additionally, my mother has hypertension and regularly takes her blood pressure medication.

Niming, 30~39 year old female. Ask Date: 2022/02/04

Dr. Lai Zhaokang reply Neurosurgery

Hello: In cases of head trauma, the most rapid changes occur within the first three days.
From January 30th to now, it has been a week, and the risk has significantly decreased.
However, in elderly individuals over 60, there is a small possibility of chronic subdural hematoma, which typically occurs 1-2 months later.
Generally, it is recommended to observe for three months.
Therefore, according to the American neurosurgical guidelines for head trauma, since your mother does not exhibit any symptoms, there is no strong indication for a CT scan.
Furthermore, considering another perspective, if your mother is doing well without any symptoms, exposing her to radiation for a CT scan may not be necessary.
Even if minor bleeding is detected, the physician's treatment recommendation would remain the same: monitoring and observation, without the need for craniotomy.
The treatment approach would be identical whether or not a CT scan is performed.
I recommend monitoring for three months, and if any abnormalities arise, such as headaches, dizziness, nausea, vomiting, seizures, poor mental status, or weakness in the limbs, seek medical attention.
Best wishes to you.
// Dr.
Lai Chao-Kang, Neurosurgery.

Reply Date: 2022/02/04

More Info

After a head injury, especially in seniors, the decision to get a CT scan can be crucial for ensuring safety and proper medical care. In your mother's case, she experienced a minor head bump without immediate symptoms such as dizziness or nausea, which is a positive sign. However, given her age and history of hypertension, it is understandable to be concerned about potential complications like chronic subdural hematoma or other forms of intracranial bleeding.

Generally, CT scans are recommended in specific situations following a head injury. The American College of Emergency Physicians and the Centers for Disease Control and Prevention provide guidelines for when a CT scan is warranted. These include:
1. Loss of Consciousness: If the person was unconscious for more than a brief moment.

2. Severe Headache: A headache that is significantly worse than usual or different from previous headaches.

3. Neurological Symptoms: Symptoms such as confusion, weakness, difficulty speaking, or seizures.

4. Persistent Vomiting: Repeated vomiting after the injury can indicate increased intracranial pressure.

5. Age Considerations: Older adults, particularly those over 65, are at a higher risk for complications from head injuries.

In your mother's case, since she did not exhibit any concerning symptoms immediately after the injury and has remained symptom-free for five days, the immediate need for a CT scan may not be necessary. However, her age and hypertension do elevate her risk profile. Chronic subdural hematomas can develop slowly, sometimes presenting weeks after the initial injury, particularly in older adults.
It is essential to monitor her for any new symptoms that may arise, such as:
- New or worsening headaches
- Dizziness or balance issues
- Changes in vision
- Confusion or memory problems
- Nausea or vomiting
If any of these symptoms develop, it would be prudent to seek medical attention and consider a CT scan.
As for the management of her hypertension, it is crucial that she continues to take her blood pressure medication as prescribed. High blood pressure can increase the risk of bleeding in the brain, so maintaining stable blood pressure levels is vital.

In summary, while your mother currently shows no alarming symptoms, her age and medical history warrant careful observation. If you notice any changes or if she develops new symptoms, do not hesitate to take her to the hospital for further evaluation, including a CT scan if deemed necessary by the healthcare provider. It’s always better to err on the side of caution when it comes to head injuries, especially in older adults.

Similar Q&A

Is a CT Scan Necessary After a Head Injury? Understanding the Risks

Hello Dr. Ding, My brother weighs about 100 kilograms and fell off his bike on a rainy, slippery road. He has a head injury with an external wound measuring approximately 7 to 10 centimeters. When bystanders brought him to the surgical clinic, he was unaware of the accident and ...

Dr. Ding Xianwei reply Neurosurgery
If it is an emergency issue, you should go directly to the emergency department for evaluation and treatment by an emergency physician. Since I cannot examine you in person, I can only provide suggestions based on your description. It sounds like you may have experienced a concus...

Understanding MRI for Head Injuries: Coverage and Availability in Taiwan

I often bump my head and want to get checked, but I'm concerned about the radiation from a CT scan. I would like to know where I can get an MRI and whether it is covered by health insurance.

Dr. Shao Guoning reply Neurosurgery
Hello Mr. PP, when you can think of this issue, it indicates that your brain's higher cortical functions are normal, and there is no need for special examinations. Generally, a CT scan of the head is required only in the following situations after head trauma: 1. Loss of con...

Understanding Concussions: Symptoms and When to Seek CT Scans

Hello Doctor, I have a question I would like to ask you. While playing basketball, I accidentally fell backward and hit the back of my head hard on the floor. I immediately felt very uncomfortable and dizzy, so I lay down to rest. However, when I woke up, my right hand was numb...

Dr. Hong Xuyi reply Neurosurgery
Hello: In response to your question about whether a CT scan is necessary for head trauma, several factors need to be considered, including the time elapsed since the injury, whether there was a loss of consciousness, any neurological deficits, and related symptoms. If symptoms pe...

Should My Daughter Get a CT Scan After a Head Injury?

If a 14-year-old girl sustained a head injury at school, resulting in a laceration to the back of her head that required five stitches, it is important to consider whether further imaging studies are necessary. Given that the doctor performed an X-ray and noted a possible skull f...

Dr. Ye Boshou reply Neurology
A 14-year-old child with head trauma is advised to first see a neurologist for a physical examination. If necessary, additional tests such as an EEG or CT scan will be arranged.