This is a basic article for medical students and other non-radiologists
Altered consciousness or confusion is a common reason for admission to hospital, and involvement of radiology 1,2.
Although the most common reason for acute confusion is intoxication which will improve - when altered neurology is present or the changes persists, more serious reasons need investigated.
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Reference article
This is a summary article; we do not have a more in-depth reference article.
Summary
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questions
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any systemic cause for confusion?
e.g. sepsis, hypoglycemia and drug interactions
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any direct causes?
e.g. trauma, pressure effects, infarction or infection
are there any focal neurological signs?
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is there any relevant medication history?
e.g. anticoagulants, alcohol, narcotics?
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investigations
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CT head is the first line investigation, especially in the acute setting
10% of patients will have a cause found 1
MRI can be performed, but usually only after CT
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making the request
what is the likely underlying cause of confusion?
what is the urgency of the study?
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common pathology
systemic infection (rarely cerebral)
intracranial hemorrhage, e.g. hemorrhagic stroke, subarachnoid hemorrhage, subdural hemorrhage, epidural hemorrhage
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