Technique for plain CT and CT angiogram of the head in an obese patient.

BACKGROUND The increase in obesity in the general population brings more frequent challenges in imaging, as an increasing number of patients exceed the weight or girth limits of existing computed tomogram (CT) or magnetic resonance (MR) scanners. We describe a technique used for plain CT and CT angiogram of the head in a morbidly obese patient. CASE REPORT A 46-year-old man presented to the emergency department describing sudden onset headache, described as the worst headache of his life and associated with nausea and vomiting. He had a complete left third cranial nerve palsy. The working diagnosis was subarachnoid haemorrhage, possibly from rupture of a left posterior communicating artery aneurysm. To confirm the diagnosis, CT head and/or lumbar puncture were contemplated. However, the patient was 6 feet 6 inches tall, and weighed 560 lbs. Lumbar puncture was considered and felt to represent a significant technical challenge. Some form of LETTERS TO THE EDITOR