Role of noncontrast head CT in the assessment of vascular abnormalities in the emergency room

Deepak Takhtani, Sathish Dundamadappa, Jeevak Almast

Research output: Contribution to journalReview articlepeer-review


Noncontrast CT of the head is a widely used noninvasive investigation for a variety of acute and chronic neurological conditions. Since CT head without contrast is usually the first and often the only investigation in the emergency room for many neurological symptoms, it is imperative to detect subtle vascular changes, which in many patients can be life-saving. The vascular abnormalities may present with increased density and/or size of the vessels, filling defects, and be associated with parenchymal and bony changes. In this article, we present examples of several vascular pathologies which can be identified on the noncontrast CT of the head, and learn imaging and interpretation techniques to help recognize what often are nebulous changes. While some of the findings are diagnostic by themselves and others subtle, any suspicious abnormality should be followed with dedicated vascular imaging such as CT/MR angiogram, venogram, or catheter angiogram for confirmation and better characterization.

Original languageEnglish (US)
Pages (from-to)529-541
Number of pages13
JournalEmergency Radiology
Issue number6
StatePublished - Dec 1 2013


  • Cord sign
  • Delta sign
  • Dural venous sinus thrombosis
  • ER
  • Empty delta sign
  • Hyperdense MCA sign
  • MCA dot sign
  • NCCT head

ASJC Scopus subject areas

  • Emergency Medicine
  • Radiology Nuclear Medicine and imaging

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