The MRI is safer than the CT scan (no radiation), so why isn’t this routinely used to follow up on a chronic subdural hematoma?
A chronic subdural hematoma is a slow brain bleed which is diagnosed with a CT scan — which emits radiation.
The initial imaging tool of choice is the CT scan. However, what about subsequent imaging for follow-ups that may occur multiple times over a short time span?
Typically, a patient who’s been diagnosed with a cSDH will undergo multiple CT scans.
“Simply, CT scan is faster and cheaper,” says Ivan Mikolaenko, MD, a board certified neurologist of 20+ years based in New York with subspecialty certification in neurocritical care.
Dr. Mikolaenko explains, “It does emit about 10 times more radiation than plain X-ray. CT examination uses an effective dose of 10 mSv; 1 mSv = 1 mGy in the case of X-rays, and it may be associated with an increase in the possibility of fatal cancer of approximately only one chance in 2,000.”
The use of a CT scan, with its speed and low cost, makes sense when someone presents to the emergency room with symptoms that suggest a suspected bleed in the brain — or an ischemic stroke.
The symptoms of a chronic subdural hematoma and an ischemic stroke are very similar.
The patient who’s concerned about radiation is free to request an MRI if their condition doesn’t warrant an as-soon-as-possible image.
But don’t expect an MRI availability in the emergency room.
CT can take 15 minutes, while magnetic resonance imaging can take an hour.
Insurance may not cover the MRI, however.
Then again, some people are willing to pay out of pocket to avoid the radiation, and don’t mind the confined nature of the MRI.
Conditions treated by Dr. Mikolaenko in the intensive care setting include strokes, ruptured aneurysms, trauma-related brain and spinal cord injuries, seizures and brain swelling, infections and tumors.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.