Emergency Radiology

, Volume 20, Issue 6, pp 529–541

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

  • Deepak Takhtani
  • Sathish Dundamadappa
  • Jeevak Almast
Review Article

DOI: 10.1007/s10140-013-1136-6

Cite this article as:
Takhtani, D., Dundamadappa, S. & Almast, J. Emerg Radiol (2013) 20: 529. doi:10.1007/s10140-013-1136-6


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.


Hyperdense MCA signDelta signDural venous sinus thrombosisERMCA dot signNCCT headEmpty delta signCord sign

Copyright information

© Am Soc Emergency Radiol 2013

Authors and Affiliations

  • Deepak Takhtani
    • 1
    • 3
  • Sathish Dundamadappa
    • 1
  • Jeevak Almast
    • 2
  1. 1.University of Massachusetts Medical SchoolUMass Memorial HospitalWorcesterUSA
  2. 2.University of Rochester Medical CenterStrong Memorial HospitalRochesterUSA
  3. 3.Department of RadiologyUMass University Medical CenterWorcesterUSA