Head Ct Koass Ri

8/10/2019 Head Ct Koass Ri

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HEAD CT SCAN Dr. Risda Fitriyani



ANATOMY



VASCULAR

SUPPLY



Ekspertise CT scan kepala noral (yang dinilai pada CT scan kepala)

• Tak tampak lesi hipodens maupun hiperdens padaintrakranial

• Differensiasi substantia alba dan grisea tampak normal

• Sulkus kortikalis dan fissura sylvii kanan kiri normal

• Ventrikel lateralis kanan kiri, III dan IV tampak normal• Cisterna perimescecephalic tampak normal

• Tak tampak midline shifting

• Pons dan cerebellum tampak normal

!S"# $• TAK TAMPAK INFARK, PERDARAHAN MAPN !O" PADA

INTRAKRANIA"

• TAK TAMPAK TANDA#TANDA PENIN$KATAN TEKANAN INTRAKRANIA"



CT CR!SS"SECT#!NAL ANAT!$Y



• Cerebral hemispher separated by falk cerebri % interhemispheric fissure

• &ray matter appears lighter $ 'hite matter

• Centrum semiovale ( hemispheric subcortical 'hite matter



The slice sho's the bodies of the lateral ventricles,

'hich appear as paired crescent)shaped CS*

spaces +t'in bananas-.



Head CT A%&i'ac&s



CT Ce''icien&s ' #%ay A&&en*a&in in

H*ns'ield ni&s



HEAD TRAMA



FRACTRE!

• Linear %ract&re

• Depressed %ract&re

• /asilar skull fracture• *rontal sinus fracture

• Pneumocephalus

• &ro'ing fracture



0inear fracture

• "1ial CT scan 'ith

bone algorithm sho's

multiple fractures of

the right frontal andparietal bones

(arrows).



Depressed *racture

• " fragment is

considered depressed

'hen its outer table is

displaced belo' thelevel of the inner table

of the skull



Pneumocephalus

• "ir loculi in thee1tracerebral spaces

typically indicate traumatic

air entry resulting from

fracture of a paranasalsinus or mastoid air cells

• 2ay be complicated by

CS* leakage, empyema,

meningitis, or brainabscess

Pneumocephalus3 Collections of air

overlie the frontal lobes and e1tend

along the anterior interhemispheric fi

ssure (arrows).



4ematomas

• Cephalhematoma• Intracerebral hematoma +IC4.

• !pidural hematoma +!D4.

• Subdural hematoma +SD4.

• Subarachnoid hemorrhage +S"4.

• Contusion

• Diffuse a1onal in5ury

• /rain stem in5ury• /rain s'elling % edema

• Penetrating in5ury

• Vascular in5ury



Intracerebral 4ematoma

• 4omogeneously

hyperdense

• Sharply marginated lesions

surrounded by a rim of

decreased density

• 2ass effect may be present• 66 sites $ frontal and

temporal lobes, basal

ganglia, posterior fossa

• 66 associated '7 othertraumatic lesions, e1 $ S"4,

SD4, IV4Intraparenchymal hematoma3 0arge,

'ell)marginated intraparenchymal

hematoma in the right parietal lobe 'ith

rupture into the ventricular system3



!pidural 4ematoma• Damage to the middle meningeal artery

• /iconve1 or lentiform shape• 66 *racture of the ad5acent bone +8.

• 0ocation $ temporal lobe +66.3 Parietal, frontal, occipital, posterior fossa

• The shape is determined by the dura Perdara'an tidak ele(ati s&t&ra



Subdural 4ematoma

• Tear the )rid*in* +eins

• The degree of mass effect seen 'ith an

SD4 is often disproportionate to the si9e

of the SD4

• 4yperdense Crescent"s'aped collection

'ith a conve1 lateral border and concave

medial border overlying the cerebral

conve1ity

• /iconcavity can be seen particularly 'henthe SD4 is large

• "cute, subacute +:); 'eeks post trauma.,

chronic +6; 'eeks post trauma.



!*+d*%al e-a&-a

Ac*&e !DH !*+ac*&e !DH C%nic !DH

Perdara'an ele(ati *aris s&t&ra



!*+a%acnid He-%%age

• 66 acutely in5ured patient % associated

'7 other lesions, e1 $ IC4

• Damage to blood vessels on the pia)

arachnoid• hyperdensity representing acute

hemorrhage is visuali9ed in t'e s&lci

overlying the cerebral conve1ities,

(it'in t'e syl+ian %iss&res, )asal

cisterns, - inter'eisp'eric %iss&re



!*+a%acnid He-%%age

• S"4 is present in the

interhemispheric and left

sylvian fi ssures, as 'ell

as in the cortical sulci of

the left frontal andtemporal lobes3

• /lood in the frontal lobe

sulci is responsible for the

i*a* appearance ofthe subarachnoid

hemorrhage3



He-%%agic Cn&*sin

•4eterogeneous increased densitymi1ed 'ith or surrounded by areas

of decreased or normal density

• 2ass effect +87).

• *rontal lobe conve1ity and the

lateral temporal areas are the most

common sites

A%ea dengan a&en*asi %enda +e%si'a& 'kal,

-*l&i'kal yang +eca-p*% dengan a%ea#a%ea

kecil +e%densi&as &inggi yang -engga-+a%kan

s*a& pe%da%aan



He-%%agic Cn&*sin

"1ial CT scan demonstrates multiple

hemorrhagic contusions in the temporal

lobes3 #ote the small left occipital lobe

conve1ity subdural hematoma (arrow).

4emorrhagic contusions 'ith

surrounding edema are evident in the

inferior left frontal and anterior right

temporal lobe(arrowheads).



.%ain s/elling 0 ede-a

• Cerebral edema may becytoto1ic, interstitial, or

vasogenic in origin

• CT findings consist of

compression of thelateral and third

ventricles and

perimesencephalic

cistern



$%ading Di''*se A1nal In2*%y('%- Ma%sall "F, e& al 3443)



TERIMAKA!IH

Head Ct Koass Ri

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