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Answer :
A CT scan of the head without contrast is indicated for a 13-year-old boy with a headache and symptoms of a closed head injury. Option 2 is correct.
The patient's symptoms and history of head injury raise concern for a possible concussion or other traumatic brain injury. A CT scan of the head without contrast is the imaging study of choice for evaluating acute head injuries, as it can detect any fractures or bleeding in the brain. A CT scan with contrast is not typically needed in this situation unless there is concern for a specific type of injury, such as a vascular injury.
Referral to a primary care physician may be appropriate for follow-up care and management of any persistent symptoms or complications related to the head injury. However, a CT scan should be performed first to assess the immediate risk of any significant injury. If the CT scan is negative but symptoms persist, further evaluation may include referral to a neurologist or neuropsychologist for assessment and management of post-concussion syndrome. Hence Option 2 is correct.
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The complete question is:
A 13-year-old boy with no past medical history presents to urgent care with a headache three days after a closed head injury. The patient states that he stood up from kneeling and hit the top of his head on a wood cabinet. There was no loss of consciousness or seizure activity. In addition to the headache, he complains of difficulty concentrating at school and dizziness. His physical examination is unremarkable. What management is indicated?
- CT scan of the head with contrast
- CT scan of the head without contrast
- MRI of the brain
- Referral to primary care physician
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