This document summarizes key information from a CT scan of the head, including: 1. It describes different types of lesions that can appear hyperdense or hypodense on CT scans and provides examples like hemorrhage, calcification, infarction, and ventricular abnormalities. 2. Pathological findings are differentiated from physiological findings. Various types of hemorrhages, infarcts, and lesions with ring enhancement are outlined. 3. Ventricular abnormalities like hydrocephalus and cerebral edema are also discussed. 4. Interpretation of CT scans involves analyzing features in bony, tissue and contrast windows to diagnose conditions like hemorrhage or infarction.

1. DR. MD. TARIFUL HOQUE

2. CT scan of
Head
Introduction
History Basics
Interpretations
Normal CT
Head
Pathological
CT Head

3. CT Head lesions
Hyperdense
(White)
Hypodense
(Black)
Isodense
with ventricular
abnormality

4. Hyperdense
(White)
Hemorrhage Calcification
Physiological Pathological

5. Hypodense
(Black)
Infarction
Single Multiple
ICSOL
Ring
enhancement
Tissue
enhancement

6. Isodence with
ventricular
abnormality
Large Ventricle
(Hydrocephalus)
Communicating Obstructive
Small Ventricle
Diffuse cerebral
oedema

7. Basics of CT Scan

18. 3 windows in CT head
1. Bony window
2. Tissue window
3. Contrast

19. Bony
window

20. Tissue
window

21. Contrast

34. Hyperdense
(White)
Hemorrhage Calcification
Physiological Pathological

38. Tuberous sclerosis

39. Gyriform Calcification
•Calcification of pial vessels
hemangioma
•Occur in Sturge weber
syndrome
•Characterized by ipsilateral
port wine stain and
contralateral seizure

40. Idiopathic hyperparathyroidism

43. Hyperdense
(White)
Hemorrhage Calcification
Physiological Pathological

44. Hemorrhagic stroke
4 types:
1. Intracerebral
2. Subarachnoid
3. Subdural
4. Extradural/Epidural
1st & 2nd are consider stroke

45. How to interpret?
This is a ct scan of head ,
multiple axial plan, non
cotrast, showing an ovoid
hyperdense area in left
temporo-parital region, sub
cortically , well circumscribed,
surrounded by rim of
hypodense area, presence of
pressure effect as evidenced by
ventricular compression and
midline shifting, so my
diagnosis is intra cranial
hemorrhage

46. More common in ganglio-thalamic region

47. Pontine Hemorrhage

48. SAH
Rupture of
anterior
communicating
artery aneurism
Rupture of
posterior
communicating
artery aneurism

49. Sub Arachnoid Hemorrhage

50. Sub Arachnoid Hemorrhage

51. Epidural Hematoma

52. Sub-dural
Hematoma
Acute Sub-acute
Acute on
chronic
Chronic

53. Acute subdural Hematoma

54. Acute on chronic subdural Hematoma

55. Sub-acute subdural Hematoma

56. Chronic subdural Hematoma

57. Hypodense
(Black)
Infarction
Single Multiple
ICSOL
Ring
enhancement
Tissue
enhancement

58. Infarction
 Infarct – maintain vascular territory
- it does not take contrast
Classification:
1. Cortical infarct
2. Subcortical infarct

59. Cerebral Arterial Territory

62. MCA Infarct (Sub-cortical)

69. Embolic infarct – MS with AF, SLE,
Vasculities

70.  1. Very large infarct
 2. Hemorrhagic diathesis
 3. Thrombolysed
 4. Pt with anti coagulant
 5. Pt with uncontrolled HTN
 6. Embolic infarct
 7. Venous infarct
Hemorrhagic transformation

71. Hemorrhagic transformation

76. SOL/ICSOL
 Well circumscribed area
 Fingerlike projection
 Doesn't maintain any vascular area
 Take contrast

77. Single ring enhancement lesion
 Primary brain tumor
 Cerebral abscess
 Single Tuberculoma
 Single metastasis

78. Single ring enhancement lesion

79. Multiple ring enhancement lesion
 Tuberculoma
 Metastasis
 Multiple brain abscess
 Multiple brain tumor
 Cysticercoids
 Hydrated cyst

81. ICSOL with tissue enhancement
Meningioma:
always attached to
one of the
meningeal coverage

82. Isodence with
ventricular
abnormality
Large Ventricle
(Hydrocephalus)
Communicating
Non-
Communicating
Small Ventricle
Diffuse cerebral
oedema

83. Small ventricles

84. Diffuse cerebral edema

85. Large Ventricle

87. Hydrocephalus
Communicating:
 Meningitis
 SAH
 NPH
Obstructive:
 Congenital aqueduct
stenosis

88. THANK YOU