Systematic Approach to Reading a Non-Contrast Head CT Scan

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Systematic Approach to Reading a Non-Contrast Head CT Scan

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Systematic Approach to Reading a Non-Contrast Head CT Scan. Systematic Approach. Assess each component of the intracranial cavity Blood Brain Bone CSF. Blood. Epidural Hematoma (EDH) Arterial Bleed: High-Pressure “Lens” Shape Middle Meningeal Laceration (Skull Fracture) - PowerPoint PPT Presentation

Transcript of Systematic Approach to Reading a Non-Contrast Head CT Scan

Page 1: Systematic Approach to Reading a Non-Contrast Head CT Scan

Systematic Approach to Reading a Non-Contrast Head CT Scan

Page 2: Systematic Approach to Reading a Non-Contrast Head CT Scan

Systematic Approach

Assess each component of the intracranial cavity

1. Blood2. Brain3. Bone4. CSF

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Blood1. Epidural Hematoma (EDH)

Arterial Bleed: High-Pressure “Lens” ShapeMiddle Meningeal Laceration (Skull Fracture)

2. Subdural Hematoma (SDH)Venous Bleed: Low-Pressure “Crescent” ShapeAcute / Chronic (Is Patient Anticoagulated? Alcoholic?)

3. Subarachnoid Hemorrhage (SAH)Traumatic / Aneurysmal

4. Intraventricular Hemorrhage (IVH)5. Intraparenchymal Hemorrhage (IPH)

Hypertensive Basal Ganglia or Lobar Cerebral Contusion “Coup-Contrecoup”

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EDH

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SDH: Acute/Chronic

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SAH (Aneurysmal)

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IVH

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IPH

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IPH

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Contusion

Coup (Red) Contrecoup Contusion (Orange) (at 180 degrees)

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Brain

1. Symmetry (of Hemispheres)Hyper-/Hypodensities (Masses, Edema, Stroke)

2. Grey/White Matter BorderLost Grey-White Differentiation in Anoxic Injury

3. Midline Shift4. Gyri/Sulci

Wide Sulci: Atrophy Effaced Sulci: Edematous “Tight/Swollen” Brain

5. Pneumocephalus (Air in Brain)Open Fracture (or Craniotomy)Fracture through Sinus

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Mass

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Midline Shift

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Sulci/Gyri: Atrophy/Edema

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Bone

1. FracturesEspecially Temporal Bones

2. Sinuses & Air CellsLook for Air-Fluid Levels

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Pneumocephalus

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Temporal Bone Fracture

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CSF: Ventricles & Cisterns

1. VentriclesBlood in Ventricles?Effacement/Asymmetry: Compression from Mass/HematomaHydrocephalusAtrophy (“Ex Vacuo”) Communicating / Obstructive HydrocephalusIf Obstructive, Where? Look at Lateral, 3rd, and 4th Ventricles

2. CisternsLook for Effacement (Edema/Early Herniation)Look for Blood

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Cisterns/Effacement

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Ventricles/Hydrocephalus

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