All of the following are indications of CT scan in head injured patient except:
**Core Concept**
In head injured patients, CT scan is a critical diagnostic tool for assessing acute hemorrhage, fractures, or other structural abnormalities in the brain. The indications for CT scan in this context are primarily focused on identifying life-threatening conditions that require immediate intervention.
**Why the Correct Answer is Right**
Option A: **Altered mental status** is a common indication for CT scan in head injured patients. This is because altered mental status can be a sign of increased intracranial pressure (ICP), which can be life-threatening. The CT scan helps to identify the underlying cause of altered mental status, such as a hemorrhage or edema.
Option B: **Seizure** is also an indication for CT scan in head injured patients. Seizures can be a manifestation of an underlying structural lesion, such as a hemorrhage or tumor. The CT scan helps to identify the cause of the seizure and guide further management.
Option C: **Focal neurological deficit** is another indication for CT scan in head injured patients. Focal neurological deficits, such as weakness or numbness, can be a sign of a structural lesion in the brain. The CT scan helps to identify the underlying cause of the deficit and guide further management.
**Why Each Wrong Option is Incorrect**
**Option D:** **Routine follow-up** is not an indication for CT scan in head injured patients. Routine follow-up is typically done with clinical evaluation and imaging only if there are new or worsening symptoms.
**Clinical Pearl / High-Yield Fact**
In head injured patients, the "spot sign" on CT scan is a high-yield finding that suggests active hemorrhage and requires immediate intervention.
**Correct Answer:** D. Routine follow-up.