Professional Documents
Culture Documents
CT
Head CT
Has assumed a critical role in the daily
practice of Emergency Medicine for
evaluating intracranial emergencies.
(e.g. Trauma, Stroke, SAH, ICH).
Most practitioners have limited
experience with interpretation.
In many situations, the Emergency
Physician must initially interpret and act
on the CT without specialist assistance.
Head CT
CT Scan Basics
A CT image is a computer-generated
picture based on multiple x-ray
exposures taken around the periphery
of the subject.
X-rays are passed through the subject,
and a scanning device measures the
transmitted radiation.
The denser the object, the more the
beam is attenuated, and hence fewer
x-rays make it to the sensor.
10
CT Scan Basics
11
2 Sheet Head CT
Posterior Fossa
Brainstem
Cerebellum
Skull Base
Clinoids
Petrosal bone
Sphenoid bone
Sella turcica
Sinuses
14
CT Scan
15
CT Scan
nd
nd
2
Key Level
Key Level
Sagittal
View
Circummesencephalic Cistern
17
Cisterns at Cerebral
Peduncles Level
18
CT Scan
19
CT Scan
20
Circummesencephalic Cistern
21
22
CT Scan
CSF Production
Produced in choroid plexus in the
lateral ventricles Foramen of
Monroe IIIrd Ventricle Acqueduct
of Sylvius IVth Ventricle
Lushka/Magendie
0.5-1 cc/min
Adult CSF volume is approx. 150 ccs.
Adult CSF production is approx. 500700 ccs per day.
24
1 day
25
1 year
2 years
B is for Blood
1st decision: Is blood present?
2nd decision: If so, where is it?
3rd decision: If so, what effect is it having?
26
B is for Blood
Acute blood is bright white
on CT (once it clots).
Blood becomes isodense
at approximately 1 week.
Blood becomes
hypodense at
approximately 2 weeks.
27
B is for Blood
Acute blood is bright white
on CT (once it clots).
Blood becomes isodense
at approximately 1 week.
Blood becomes
hypodense at
approximately 2 weeks.
28
B is for Blood
Acute blood is bright white
on CT (once it clots).
Blood becomes isodense
at approximately 1 week.
Blood becomes
hypodense at
approximately 2 weeks.
29
CT Scans
30
Subdural Hematoma
Typically falx or sickleshaped.
Crosses sutures, but does
not cross midline.
Acute subdural is a marker
for severe head injury.
(Mortality approaches
80%)
Chronic subdural usually
slow venous bleed and
well tolerated.
31
Subarachnoid Hemorrhage
32
Subarachnoid Hemorrhage
Blood in the cisterns/cortical gyral surface
33
CT Scan
34
CT Scan
35
Intraventricular/
Intraparenchymal
Hemorrhage
CT Scan
37
C is for CISTERNS
(Blood Can Be Very Bad)
4 key cisterns
Circummesencephalic
Suprasellar
Quadrigeminal
Sylvian
Circummesencephalic
38
Cisterns
39
40
41
B is for BRAIN
(Blood Can Be Very Bad)
42
43
Tumor
44
Atrophy
45
Abscess
46
Hemorrhagic Contusion
47
Mass Effect
48
Intracranial Air
49
Intracranial Air
50
51
52
53
54
55
56
Text Book
David Suttons Radiology
Clarks Radiographic positioning and techniques
Assignment
Two students will be selected for assignment.
Question
Define differences between subdural and epidural
hematoma?
Thank You