CT -scan of head

[Akino]

Hi again,

did anyone have a CT-scan of the head to find out more about GCA?

And if so, what results can be expected?

I'll have a CT-scan next week and don't know what to expect from it and couldn't find much about it on the web.

I adjust more and more to my condition now. Still big problems with spoon management for sure. Some days are just sofa days, some are more like in my old life. I'm reading here almost every day and it gives me reassurance and hope and information.

So, if you have something you could share about the CT-scan it would be very helpful. Thank you, Monika

[SnazzyD]

Hello. I'm on treatment for strongly suspected GCA since A&E last weekend. They did a CT scan of my head not to diagnose the GCA but to rule out other things because of my previous medical history. The guidelines I've read this week in my crash course in GCA don't cite CT as routine for diagnosis.

Anyway, the procedure is not traumatic. If it is for your head it is not the sort of scan where you are posted into a tube; more like a giant doughnut. At all times I could see the room. It took a few minutes only. It isn't noisy, just a whirring sound and you might see a small window in the doughnut where you can see the insides spinning round. The bed slides in and out automatically. The operator stands behind the glass with their monitors. You must lie very still but it is really quite peaceful.

If they want to see your blood vessels more clearly, they will give you some tracer through a small line in a vein. Not one of the bigger ones that need to give you fluids like in hospital. It works very quickly so no sitting around like with some tracers. When it goes round your body the first time it feels like a warm flush then that's it you feel nothing. This might be too much detail but it needs to be said I case it makes you move - You might suddenly feel you are peeing yourself. This is because the flush in the blood vessels goes everywhere so it feels like warm wee! You are not really doing it! It passes in seconds.

On that note, I wish you luck.

[PMRpro Ambassador]

As far as I know it is rarely used in GCA - if it showed a lot they would use it rather than a TAB I would have thought. As Snazzy says, it is more likely to rule out other things. PET-CT is useful for GCA involving the aorta and other arteries in the trunk - but not for the head as the brain takes up enormous amounts of the tracer and that is so overwhelming nothing can be seen of other arteries in the head.

emedicine.medscape.com/arti...

says this:

"Thickening of the arterial walls, stenosis, or occlusion may be demonstrated on contrast-enhanced computed tomography (CT) scans. However, CT scanning commonly fails to depict mild inflammatory changes in the vessels. CT is not useful for the evaluation of small-vessel disease. In older persons, disease processes such as atherosclerotic disease are far more common than temporal arteritis and may result in similar CT findings."

The entire article is good - you may have to sign up to read it but anyone can join Medscape free.

I can't tell you about CT - I don't remember either of the ones I have had! I do know that it isn't loud like MRI!

[piglette]

I had a CT scan a couple of weeks ago. I had never had one before. Everyone else had to wear those awful robe things that have a gap at the back, but I didn't for some unknown reason. I just wore my own clothes. We all queued up in the waiting area and it was quite jolly chatting away. It took minutes, time for me to lie down on the table, get my arms out of the way and to then be xrayed. I waited a few minutes afterwards in the hospital to ensure I did not get any side effects from the contrast media. I did not have the feeling of wanting to wee or a metallic taste in my mouth for a second or two at the time of the scan which can happen with the media. I kept my eyes shut so cannot tell you what actually happened!

[Brantuk]

Hi Monika

I've had 5 of these CT scans now since Nov 2015 and they are exactly as SnazzyD says above. I've had head only, head and thorax, as well as thorax and abdomen scans. They've been used to examine the shape and size of my major arteries and aorta. They're also used to examine for any swellings in the head after a fall, and any arterial swelling as a result of blocked arteries.

For GCA though CT scans don't indicate existence of inflamation in the arteries. For that they need to do a PET scan - I had one last year and due for another soon. They pump an amount of radioactive tracer in for a PET scan and the bed slides you into a full body length tunnel for 30-40mins - and it can be very claustrophobic. But it's the only way they can see arterial inflammation short of a temporal biopsy.

I'm sure amongst other things, they will be taking a close look at your carotid artery for signs of furring up, or arterial narrowing and swelling, like they have done with me. The good news is a CT scan only takes about ten mins and it's not claustrophobic at all. Hope my experience helps ease you through the process.

[SnazzyD in reply to Brantuk]

I'm glad you mentioned the PET scan. I've got one coming and have not had one before but found an MRI years ago traumatic due to claustrophobia. Now I know to take some eye patches to cover them before I slide in and I'll do some mental prep this time!

[Akino]

Well, I see. Thank you all again. Makes it clearer now what to expect. Hope they don't find anything. It's a little scary. The procedure itself seems to be acceptable. Thank you for taking the time. Much appreciated. Monika