CT brain hemorrhage
The basic principles of the CT brain examination, focused on intracerebral hemorrhage.
Table of contents
Checklist
The following points can be used as a guide to assess a brain CT to demonstrate/exclude a hemorrhage.
1. Brain parenchyma:
- Is there asymmetry anywhere or obliteration of the gyri sulci pattern?
- Abnormal gray-white matter differentiation?
- Hypo/hyperdense abnormalities?
2. Hemorrhage
- Type/cause/location?
- Subarachnoid cisterns; obliteration of the W shape, pentagon, moon shape, Sylvian fissure?
- Mass effect or signs of herniation? is there still space around the brain stem?
3. Ventricular system:
- Hydrocephalus?
- Intraventricular blood?
4. Bone:
- Extracranial soft tissue swelling?
- Fracture? Pneumocephalus?
- Normal air content of the sinuses and the mastoid? Air-fluid (blood) levels in the sinus? (CAUTION: fracture!)
5. Old examinations:
- New findings?
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Literature: sources and author
Text & Illustrations
drs. A. van der Plas, MSK radiologist Maastricht UMC+
Sources:
- D. M. Yousem et al; The Requisites – Neuroradiology (2010)
- J. B. M. Kuks,J.W. Snoek; Klinische neurologie (2007)
- M. Schünke, E.Schulte, U.Schumacher; Anatomische atlas Prometheus: Hoofd, hals en neuroanatomie (2007)
- A.D. Perron et al; A multicenter study to improve emergency medicine residents’ recognition of intracranial emergencies on computed tomography. Ann Emerg Med. 1998.
- M. Prokop et al; Spiral and Multislice Computed Tomography of the body (2003)
09/03/2014
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