Spiral head CT in the evaluation of acute intracranial pathology: a pictorial essay.

The purpose of this pictorial essay is to review the benefits of spiral head computed tomography (CT) with routine multiplanar reformations in the evaluation of acute intracranial pathology. This technique is particularly useful in trauma patients for detection of skull base or calvarial fractures, thin tentorial subdural hematomas, or for more specific characterization of intracranial hemorrhage. The benefits of multiplanar reformations have been described for a variety of other diagnoses in the chest, abdomen, extremities, and spine, and their routine use continues to grow with the widespread availability of multi-slice CT scanners. In this article, we describe spiral head CT technique with multiplanar reformations as an alternative to the routinely used sequential technique. Subtle findings and lesions aligned predominantly in the axial plane can often be visualized to better advantage with multiplanar reformations. We also address technical factors for optimizing spiral technique.