This document provides an overview of how to systematically analyze a head CT scan. It begins with identifying patient information and scan parameters. It then describes how to examine different regions of the brain from midline structures outward, including ventricles, cisterns, brain parenchyma, sulci, sinuses, bones, and soft tissues. Key things to evaluate for in each region are discussed, such as midline shift, masses, hemorrhages, fractures, and more. Two case examples are then presented to demonstrate application of the approach.
This document provides an overview of basic brain CT, including its principles, anatomy, common pathologies, and interpretation. It discusses how CT uses X-rays to reconstruct cross-sectional images and analyze tissue density. Key points covered include the appearance of skull fractures, hemorrhages, infarcts, tumors, infections and other intracranial abnormalities. Understanding normal anatomy is emphasized to aid in detecting abnormalities.
The document discusses the radiological anatomy of a normal CT brain scan. It begins by describing the lobes of the brain and surfaces visible on CT. It then discusses the history and technique of CT scanning, describing how different tissues appear in varying shades of gray. Common artifacts are also reviewed. Key features of a normal CT brain include symmetric ventricles and sulci, with intact skull and no masses or fluid collections seen.
This document provides information about brain anatomy, including the embryology and major structures of the brain. It describes the main parts of the brain including the forebrain (prosencephalon), midbrain (mesencephalon), and hindbrain (rhombencephalon). Within these sections it outlines structures like the telencephalon, diencephalon, thalamus, hypothalamus, cerebral cortex, basal ganglia, brainstem, and cerebellum. It also provides some key details about fiber types and blood supply to different brain regions.
Radiological imaging of mediastinal massesPankaj Kaira
1. CT is the most important tool for evaluating mediastinal masses and characterizing their nature and extent.
2. Thymomas are the most common primary mediastinal neoplasm, typically occurring in patients over 40 and appearing on CT as well-defined solid masses in the anterior mediastinum that can demonstrate calcification.
3. CT is useful for staging thymomas and identifying features like invasion of surrounding tissues or distant metastases that indicate more advanced disease.
The document provides detailed information about the anatomy and physiology of the brain and head. It describes the three main parts of the brain - the cerebrum, cerebellum and brain stem. It discusses the lobes of the cerebrum and various deep brain structures. The document then covers the skull, use of CT scanning to image the brain, the CT scanning procedure, common pathologies visible on brain CT scans, and provides examples of labeled brain CT images.
The document provides guidance on reading head CT scans for physicians. It outlines the basic principles of CT scanning, including its history and components. It then reviews normal neuroanatomy as seen on head CT scans, illustrating various anatomical structures and landmarks visible in different axial sections. The document aims to help physicians accurately interpret CT findings to diagnose and treat time-sensitive conditions without specialist assistance.
CT scans of the brain can identify several abnormalities. Non-contrast CT scans can detect hemorrhages and infarcts, while contrast CT scans can better identify tumors and sites of infection. Interpretation of CT scans requires understanding Hounsfield units to characterize lesions as hyperdense or hypodense compared to brain tissue. Physicians must also be familiar with the vascular supply of different brain regions to localize lesions.
CT Brain Interpretation document provides information about CT imaging of the brain. It discusses the basic principles of CT imaging including how cross-sectional images are obtained. It describes how to interpret a normal CT brain scan using different window settings. The document outlines neuroanatomy and labels structures visible on CT images at different brain levels. It provides guidance on reporting findings from a CT brain scan.
This document provides an overview of basic brain CT, including its principles, anatomy, common pathologies, and interpretation. It discusses how CT uses X-rays to reconstruct cross-sectional images and analyze tissue density. Key points covered include the appearance of skull fractures, hemorrhages, infarcts, tumors, infections and other intracranial abnormalities. Understanding normal anatomy is emphasized to aid in detecting abnormalities.
The document discusses the radiological anatomy of a normal CT brain scan. It begins by describing the lobes of the brain and surfaces visible on CT. It then discusses the history and technique of CT scanning, describing how different tissues appear in varying shades of gray. Common artifacts are also reviewed. Key features of a normal CT brain include symmetric ventricles and sulci, with intact skull and no masses or fluid collections seen.
This document provides information about brain anatomy, including the embryology and major structures of the brain. It describes the main parts of the brain including the forebrain (prosencephalon), midbrain (mesencephalon), and hindbrain (rhombencephalon). Within these sections it outlines structures like the telencephalon, diencephalon, thalamus, hypothalamus, cerebral cortex, basal ganglia, brainstem, and cerebellum. It also provides some key details about fiber types and blood supply to different brain regions.
Radiological imaging of mediastinal massesPankaj Kaira
1. CT is the most important tool for evaluating mediastinal masses and characterizing their nature and extent.
2. Thymomas are the most common primary mediastinal neoplasm, typically occurring in patients over 40 and appearing on CT as well-defined solid masses in the anterior mediastinum that can demonstrate calcification.
3. CT is useful for staging thymomas and identifying features like invasion of surrounding tissues or distant metastases that indicate more advanced disease.
The document provides detailed information about the anatomy and physiology of the brain and head. It describes the three main parts of the brain - the cerebrum, cerebellum and brain stem. It discusses the lobes of the cerebrum and various deep brain structures. The document then covers the skull, use of CT scanning to image the brain, the CT scanning procedure, common pathologies visible on brain CT scans, and provides examples of labeled brain CT images.
The document provides guidance on reading head CT scans for physicians. It outlines the basic principles of CT scanning, including its history and components. It then reviews normal neuroanatomy as seen on head CT scans, illustrating various anatomical structures and landmarks visible in different axial sections. The document aims to help physicians accurately interpret CT findings to diagnose and treat time-sensitive conditions without specialist assistance.
CT scans of the brain can identify several abnormalities. Non-contrast CT scans can detect hemorrhages and infarcts, while contrast CT scans can better identify tumors and sites of infection. Interpretation of CT scans requires understanding Hounsfield units to characterize lesions as hyperdense or hypodense compared to brain tissue. Physicians must also be familiar with the vascular supply of different brain regions to localize lesions.
CT Brain Interpretation document provides information about CT imaging of the brain. It discusses the basic principles of CT imaging including how cross-sectional images are obtained. It describes how to interpret a normal CT brain scan using different window settings. The document outlines neuroanatomy and labels structures visible on CT images at different brain levels. It provides guidance on reporting findings from a CT brain scan.
CT imaging of Brain in Clinical Practice by Dr. Vaibhav Yawalkarvaibhavyawalkar
Cranial CT is a useful diagnostic tool in the emergency room that physicians need to be able to accurately interpret without specialist assistance. CT imaging works by passing collimated X-rays through the patient which are detected on the other side and assembled into cross-sectional images. Different tissues absorb X-rays to different degrees, appearing as different shades of grey on the image. The "blood can be very bad" mnemonic directs physicians to examine the blood, cisterns, brain, ventricles, and bone for abnormalities such as hemorrhage, increased intracranial pressure, infarcts, and space-occupying lesions. Contrast injection helps identify enhancing lesions including tumors, abscesses, and infections
Brain imaging is important in trauma to identify injuries from primary impact and secondary complications. CT is best for acute trauma to detect fractures and hemorrhages while MRI is more sensitive for diffuse injuries. Common primary injuries seen include fractures, contusions, hematomas, shearing injuries and hemorrhages in various locations. Secondary complications can include swelling, infection and herniations putting pressure on vessels.
Presentation1.pptx, radiological anatomy of the brain.Abdellah Nazeer
This document provides an overview of the radiological anatomy of the brain through computed tomography (CT) imaging. It describes the skull bones and sutures that form the cranial vault, as well as the three cranial fossae that house different brain structures. It also discusses the meningeal layers, including the falx cerebri and tentorium cerebelli, and cerebrospinal fluid spaces within the brain. Key structures like the pituitary fossa and ventricular system are identified. Understanding the normal CT anatomy of the brain provides important context for radiological interpretation.
MRI brain; Basics and Radiological AnatomyImran Rizvi
MRI BRAIN BASICS AND RADIOLOGICAL ANATOMY
1. MRI uses strong magnetic fields and radio waves to produce detailed images of the brain and detect abnormalities. It has largely replaced CT for evaluating many conditions due to its superior soft tissue contrast.
2. Different MRI sequences such as T1-weighted, T2-weighted, FLAIR and DWI highlight various tissues and pathologies based on their relaxation properties. T1 highlights anatomy while T2 highlights abnormalities like tumors and inflammation.
3. Key anatomical structures are clearly visualized on MRI slices through different levels of the brain. Axial slices progress from the brainstem to the cortex, while sagittal slices show deep midline structures
Presentation1.pptx, radiological imaging of hydrocephalus.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating hydrocephalus. It describes various imaging findings in different types of hydrocephalus like congenital hydrocephalus and hydrocephalus secondary to tumors. It focuses on techniques for evaluating normal pressure hydrocephalus (NPH), including phase contrast MRI to quantify cerebrospinal fluid flow. It hypothesizes that NPH may be caused by a combination of naturally enlarged ventricles and later deep white matter ischemia restricting CSF flow, leading to symptomatic hydrocephalus. Quantitative CSF flow studies can help diagnose shunt-responsive NPH.
Normal & abnormal radiology of brain part iiMohammed Fathy
This document provides an overview of radiology techniques used to image the central nervous system (CNS), with a focus on brain tumors. It discusses the roles of various imaging modalities like CT, MRI, X-rays and their sequences. CT provides density-based images and is useful for detecting calcification. MRI has better soft tissue contrast and avoids radiation. Key MRI sequences like T1WI, T2WI, FLAIR, DWI, PWI, and post-contrast T1WI are explained. These sequences help characterize lesions and determine tumor type and grade. Perfusion imaging can indicate malignancy by showing blood flow and volume within a tumor. Together modern imaging allows diagnosis, staging, treatment planning and monitoring
1) The document provides an overview of the normal anatomical structures visible on CT scans of the brain, including the skull, meninges, ventricles, lobes, grey and white matter structures.
2) Key structures discussed include the cerebrum, cerebellum, brainstem, basal ganglia, thalamus, internal capsules, and corpus callosum.
3) The techniques for performing head CT scans are outlined, along with slice thickness and use of intravenous contrast.
The document describes a case of a 27-year-old man presenting with chronic dry cough and referred for chest imaging. Chest x-ray revealed a well-defined round radio-opaque lesion in the left perihilar region. Further imaging found the mass to be arising from the left main bronchus in the middle mediastinum. Differential diagnoses included bronchogenic cysts and esophageal duplication cysts. Based on features of a sharply demarcated mass arising from the bronchus, the final diagnosis was determined to be a bronchogenic cyst, a congenital malformation of the bronchial tree.
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
Acute Pediatric Neuroradiology: Pearls and Pitfalls (2020)Felice D'Arco
This document discusses several topics related to pediatric head CT scans:
- Indications for pediatric head CT scans including suspected non-accidental injury, post-traumatic seizures, and suspected skull fractures.
- Differences in pediatric neuroanatomy compared to adults, such as ongoing myelination processes.
- Common conditions seen on pediatric head CT such as hydrocephalus, infections like mastoiditis and abscesses, and brain tumors.
- The importance of considering non-accidental trauma when evaluating head injuries in children.
- Limiting unnecessary CT scans in children by understanding myths around their use for conditions like meningitis.
Perfusion MRI (DSC and DCE perfusion techniques) for radiology residentsRiham Dessouky
This document provides an overview of perfusion weighted MR imaging techniques. It discusses three main types: dynamic susceptibility contrast (DSC) MR perfusion, dynamic contrast enhanced (DCE) MR perfusion, and arterial spin labeling (ASL) MR perfusion. DSC relies on signal loss from gadolinium contrast to measure parameters like relative cerebral blood volume (rCBV) and flow (rCBF). DCE uses T1 shortening effects of contrast to calculate permeability and perfusion. Both techniques are used to evaluate brain tumors and strokes by analyzing signal intensity curves. DCE is also used in breast MRI to classify enhancement curves and measure permeability with the Ktrans parameter.
Presentation1.pptx, radiological imaging of cerebral ischemia.Abdellah Nazeer
This document summarizes radiological imaging techniques for diagnosing and characterizing cerebral ischemia (lack of blood flow to the brain). CT and MRI are useful for detecting early signs of ischemia and identifying the location and size of infarcts (areas of dead brain tissue). CT perfusion and angiography can further identify regions of critically low blood flow termed the "ischemic penumbra" that may be salvaged by rapid reperfusion. Different sequences on MRI such as DWI, T2, and T1 weighted imaging can detect ischemia at various time points and characterize the progression of injury over time. Together, these advanced imaging modalities aid in diagnosis, prognosis, and guiding of acute stroke treatment.
This document describes schizencephaly, a rare brain malformation characterized by clefts that extend from the ventricles to the brain surface. It is caused by failed neuronal migration during early gestation. On imaging, schizencephaly appears as grey matter-lined clefts and is classified as open or closed lip. It is associated with other cortical abnormalities and presents variably with seizures, weakness, or developmental delays depending on extent of involvement.
Radiology of Brain hemorrhage vs infarctionthamir22
this presentaion is free for every medical student
by the end of this presentation you will be able to identify cerebral strokes and determine the age of the pathology
good luck .. Dr Thamir alotaify
This document provides an overview of brain CT, including its history, principles, indications, anatomy, and normal findings. It discusses how CT uses X-rays to reconstruct high-definition cross-sectional images of the brain, and how densities are described. Key indications for brain CT include acute stroke, head injury, and mental status changes. Normal anatomy seen on CT includes the ventricles, sulci and fissures, basal ganglia, and pineal and choroid plexus calcifications in many adults. The document outlines important axial slice locations and normal variations to aid physicians in accurate CT interpretation.
This document discusses CT imaging techniques for evaluating acute stroke. It describes CT perfusion imaging which uses a contrast agent bolus to evaluate cerebral blood flow, cerebral blood volume, and mean transit time. These perfusion values can identify the ischemic core with very low blood flow as well as the penumbra of salvageable tissue at risk for infarction. CT angiography is also discussed for evaluating vessel occlusion in thromboembolic stroke.
The document summarizes the anatomy and contents of various brain cisterns. It describes the locations and structures contained within several major cisterns, including:
1) The cisterna magna, which contains the cerebellar medullary veins and lower cranial nerves.
2) The interpeduncular cistern, which is divided by membranes and contains the basilar artery, posterior cerebral arteries, and cranial nerves 3 and 6.
3) The ambient cistern, which surrounds the midbrain and contains the posterior cerebral artery and cranial nerve 4.
4) The suprasellar/chiasmatic cistern, located above the pituitary fossa,
CT imaging of Brain in Clinical Practice by Dr. Vaibhav Yawalkarvaibhavyawalkar
Cranial CT is a useful diagnostic tool in the emergency room that physicians need to be able to accurately interpret without specialist assistance. CT imaging works by passing collimated X-rays through the patient which are detected on the other side and assembled into cross-sectional images. Different tissues absorb X-rays to different degrees, appearing as different shades of grey on the image. The "blood can be very bad" mnemonic directs physicians to examine the blood, cisterns, brain, ventricles, and bone for abnormalities such as hemorrhage, increased intracranial pressure, infarcts, and space-occupying lesions. Contrast injection helps identify enhancing lesions including tumors, abscesses, and infections
Brain imaging is important in trauma to identify injuries from primary impact and secondary complications. CT is best for acute trauma to detect fractures and hemorrhages while MRI is more sensitive for diffuse injuries. Common primary injuries seen include fractures, contusions, hematomas, shearing injuries and hemorrhages in various locations. Secondary complications can include swelling, infection and herniations putting pressure on vessels.
Presentation1.pptx, radiological anatomy of the brain.Abdellah Nazeer
This document provides an overview of the radiological anatomy of the brain through computed tomography (CT) imaging. It describes the skull bones and sutures that form the cranial vault, as well as the three cranial fossae that house different brain structures. It also discusses the meningeal layers, including the falx cerebri and tentorium cerebelli, and cerebrospinal fluid spaces within the brain. Key structures like the pituitary fossa and ventricular system are identified. Understanding the normal CT anatomy of the brain provides important context for radiological interpretation.
MRI brain; Basics and Radiological AnatomyImran Rizvi
MRI BRAIN BASICS AND RADIOLOGICAL ANATOMY
1. MRI uses strong magnetic fields and radio waves to produce detailed images of the brain and detect abnormalities. It has largely replaced CT for evaluating many conditions due to its superior soft tissue contrast.
2. Different MRI sequences such as T1-weighted, T2-weighted, FLAIR and DWI highlight various tissues and pathologies based on their relaxation properties. T1 highlights anatomy while T2 highlights abnormalities like tumors and inflammation.
3. Key anatomical structures are clearly visualized on MRI slices through different levels of the brain. Axial slices progress from the brainstem to the cortex, while sagittal slices show deep midline structures
Presentation1.pptx, radiological imaging of hydrocephalus.Abdellah Nazeer
This document discusses radiological imaging techniques for evaluating hydrocephalus. It describes various imaging findings in different types of hydrocephalus like congenital hydrocephalus and hydrocephalus secondary to tumors. It focuses on techniques for evaluating normal pressure hydrocephalus (NPH), including phase contrast MRI to quantify cerebrospinal fluid flow. It hypothesizes that NPH may be caused by a combination of naturally enlarged ventricles and later deep white matter ischemia restricting CSF flow, leading to symptomatic hydrocephalus. Quantitative CSF flow studies can help diagnose shunt-responsive NPH.
Normal & abnormal radiology of brain part iiMohammed Fathy
This document provides an overview of radiology techniques used to image the central nervous system (CNS), with a focus on brain tumors. It discusses the roles of various imaging modalities like CT, MRI, X-rays and their sequences. CT provides density-based images and is useful for detecting calcification. MRI has better soft tissue contrast and avoids radiation. Key MRI sequences like T1WI, T2WI, FLAIR, DWI, PWI, and post-contrast T1WI are explained. These sequences help characterize lesions and determine tumor type and grade. Perfusion imaging can indicate malignancy by showing blood flow and volume within a tumor. Together modern imaging allows diagnosis, staging, treatment planning and monitoring
1) The document provides an overview of the normal anatomical structures visible on CT scans of the brain, including the skull, meninges, ventricles, lobes, grey and white matter structures.
2) Key structures discussed include the cerebrum, cerebellum, brainstem, basal ganglia, thalamus, internal capsules, and corpus callosum.
3) The techniques for performing head CT scans are outlined, along with slice thickness and use of intravenous contrast.
The document describes a case of a 27-year-old man presenting with chronic dry cough and referred for chest imaging. Chest x-ray revealed a well-defined round radio-opaque lesion in the left perihilar region. Further imaging found the mass to be arising from the left main bronchus in the middle mediastinum. Differential diagnoses included bronchogenic cysts and esophageal duplication cysts. Based on features of a sharply demarcated mass arising from the bronchus, the final diagnosis was determined to be a bronchogenic cyst, a congenital malformation of the bronchial tree.
This document provides information on the ventricular system of the brain. It describes the lateral ventricles, third ventricle, cerebral aqueduct, and fourth ventricle. It discusses the relations, choroid plexuses, and radiological appearance of each part of the ventricular system. Radiological features on plain X-rays, CT, and MRI are also summarized.
Acute Pediatric Neuroradiology: Pearls and Pitfalls (2020)Felice D'Arco
This document discusses several topics related to pediatric head CT scans:
- Indications for pediatric head CT scans including suspected non-accidental injury, post-traumatic seizures, and suspected skull fractures.
- Differences in pediatric neuroanatomy compared to adults, such as ongoing myelination processes.
- Common conditions seen on pediatric head CT such as hydrocephalus, infections like mastoiditis and abscesses, and brain tumors.
- The importance of considering non-accidental trauma when evaluating head injuries in children.
- Limiting unnecessary CT scans in children by understanding myths around their use for conditions like meningitis.
Perfusion MRI (DSC and DCE perfusion techniques) for radiology residentsRiham Dessouky
This document provides an overview of perfusion weighted MR imaging techniques. It discusses three main types: dynamic susceptibility contrast (DSC) MR perfusion, dynamic contrast enhanced (DCE) MR perfusion, and arterial spin labeling (ASL) MR perfusion. DSC relies on signal loss from gadolinium contrast to measure parameters like relative cerebral blood volume (rCBV) and flow (rCBF). DCE uses T1 shortening effects of contrast to calculate permeability and perfusion. Both techniques are used to evaluate brain tumors and strokes by analyzing signal intensity curves. DCE is also used in breast MRI to classify enhancement curves and measure permeability with the Ktrans parameter.
Presentation1.pptx, radiological imaging of cerebral ischemia.Abdellah Nazeer
This document summarizes radiological imaging techniques for diagnosing and characterizing cerebral ischemia (lack of blood flow to the brain). CT and MRI are useful for detecting early signs of ischemia and identifying the location and size of infarcts (areas of dead brain tissue). CT perfusion and angiography can further identify regions of critically low blood flow termed the "ischemic penumbra" that may be salvaged by rapid reperfusion. Different sequences on MRI such as DWI, T2, and T1 weighted imaging can detect ischemia at various time points and characterize the progression of injury over time. Together, these advanced imaging modalities aid in diagnosis, prognosis, and guiding of acute stroke treatment.
This document describes schizencephaly, a rare brain malformation characterized by clefts that extend from the ventricles to the brain surface. It is caused by failed neuronal migration during early gestation. On imaging, schizencephaly appears as grey matter-lined clefts and is classified as open or closed lip. It is associated with other cortical abnormalities and presents variably with seizures, weakness, or developmental delays depending on extent of involvement.
Radiology of Brain hemorrhage vs infarctionthamir22
this presentaion is free for every medical student
by the end of this presentation you will be able to identify cerebral strokes and determine the age of the pathology
good luck .. Dr Thamir alotaify
This document provides an overview of brain CT, including its history, principles, indications, anatomy, and normal findings. It discusses how CT uses X-rays to reconstruct high-definition cross-sectional images of the brain, and how densities are described. Key indications for brain CT include acute stroke, head injury, and mental status changes. Normal anatomy seen on CT includes the ventricles, sulci and fissures, basal ganglia, and pineal and choroid plexus calcifications in many adults. The document outlines important axial slice locations and normal variations to aid physicians in accurate CT interpretation.
This document discusses CT imaging techniques for evaluating acute stroke. It describes CT perfusion imaging which uses a contrast agent bolus to evaluate cerebral blood flow, cerebral blood volume, and mean transit time. These perfusion values can identify the ischemic core with very low blood flow as well as the penumbra of salvageable tissue at risk for infarction. CT angiography is also discussed for evaluating vessel occlusion in thromboembolic stroke.
The document summarizes the anatomy and contents of various brain cisterns. It describes the locations and structures contained within several major cisterns, including:
1) The cisterna magna, which contains the cerebellar medullary veins and lower cranial nerves.
2) The interpeduncular cistern, which is divided by membranes and contains the basilar artery, posterior cerebral arteries, and cranial nerves 3 and 6.
3) The ambient cistern, which surrounds the midbrain and contains the posterior cerebral artery and cranial nerve 4.
4) The suprasellar/chiasmatic cistern, located above the pituitary fossa,
This document provides guidance on evaluating head CT scans and cervical spine x-rays. For head CTs, the key things to examine are midline structures, symmetry between sides, basal cisterns, and ventricles. Cervical spine x-rays should be evaluated for fractures, alignment of vertebrae, and abnormal spacing between vertebrae. CT and MRI may also be useful to identify ligament or bone marrow injuries in the cervical spine. The document emphasizes the importance of systematic evaluation of standard imaging views of the head and neck for trauma.
A 33-year-old woman presented to the emergency department after being struck behind the right ear by a flying baseball bat at a baseball game. She reported pain, tinnitus, dizziness, and slurred speech but denied loss of consciousness or nausea. Examination revealed right facial motor weakness, tenderness over the right mastoid bone, and right hemotympanum. CT scan showed a transverse temporal bone fracture and air in the internal auditory canal, consistent with a basilar skull fracture.
1. The document discusses the anatomy and imaging features of cerebrospinal fluid (CSF) cisterns and spaces. It describes the locations and contents of various cisterns such as the interpeduncular, chiasmatic, crural, ambient and cerebellomedullary cisterns.
2. Imaging findings of different pathological conditions are presented, including benign external hydrocephalus, subdural hematoma, hydrocephalus, atrophy and periventricular leukomalacia. Key distinguishing features between these entities are highlighted.
3. An overview of CSF spaces is given, outlining the appearance of normal, atrophic and edematous/hydrocephalic states.
Acute management of Stroke By Dr Sanjay jaiswal Neurologist sept2012Sanjay Jaiswal
The document discusses early management of ischemic stroke. It defines stroke as a sudden neurological deficit of vascular origin lasting more than 24 hours. It emphasizes that "time is brain" and every minute of untreated stroke causes the loss of 1.9 million neurons. It outlines risk factors, signs and symptoms of different types of stroke, and the definition of transient ischemic attack. Current acute treatments for ischemic stroke including thrombolysis within 3-4.5 hours and aspirin within 48 hours are discussed.
This document provides an overview of how to systematically analyze a head CT scan. It begins with identifying basic scan details and checking for previous studies. It then reviews CT fundamentals like Hounsfield units and image planes. The document outlines an approach of analyzing midline structures, ventricles, cisterns, brain parenchyma, sulci, sinuses, and bones. It provides examples of common abnormalities and how to identify acute vs. chronic hemorrhages. The goal is to familiarize readers with head CT anatomy and classic abnormalities.
The document provides an overview of brain anatomy and various types of head injuries and brain hemorrhages that can be seen on CT imaging. It begins with a brief description of brain anatomy including skull bones, meninges, ventricles, and cortical structures. It then discusses different types of head trauma such as skull fractures, depressed fractures, and basilar fractures. Finally, it covers brain hemorrhages including extra-axial hemorrhages like epidural hematomas and subdural hematomas, as well as subarachnoid hemorrhage and intra-axial bleeding.
This document provides guidance on reading and interpreting chest x-rays. It begins by identifying the different lung zones and providing a stepwise approach to examining a CXR, including assessing technical quality, position, inspiration, exposure, and rotation. It then describes how to systematically examine the image from center to periphery, looking at grey scale, position, size and shape of structures at each step. Common findings are described, such as consolidation, pneumothorax, cardiomegaly, and foreign bodies. Guidance is also provided on interpreting cervical spine x-rays and CT brain images in trauma.
This document provides information about performing and interpreting head CT scans. It discusses:
1. How a head CT is performed, including positioning the patient supine and rotating the x-ray tube around the head.
2. Key aspects of head CT scans like typical slice thickness of 5-10mm, use of contrast, and transverse plane images.
3. Interpreting head CTs by understanding Hounsfield units and attenuation values of different tissues, as well as normal cranial anatomy visible on scans.
4. Common pathologies that can be identified on head CTs such as traumatic injuries, hemorrhages, strokes, and tumors.
This document provides an introduction to head CT imaging. It discusses the basics of CT, including how it uses x-rays to provide axial brain views and measures tissue density. It outlines an ABBBC approach to reading CT scans, focusing on air-filled structures, bones, blood, brain tissue, and CSF spaces. The document reviews normal brain anatomy and identifies various pathologies that can be seen on head CT such as hemorrhages, infarcts, masses and herniations. It provides examples of interpreting CT scans using the ABBBC method.
This document provides an introduction to head CT imaging. It discusses the basics of CT, including how it uses x-rays to provide axial brain views and measures tissue density. It outlines an ABBBC approach to reading CT scans, focusing on air-filled structures, bones, blood, brain tissue, and CSF spaces. The document reviews normal brain anatomy and identifies various pathologies that can be seen on head CT such as hemorrhages, infarcts, masses and herniations. It provides examples of interpreting CT scans using the ABBBC method.
This document summarizes key structures and features seen on CT scans of the brain. It describes gray and white matter, cranial fossa, lobes, and brain stems such as the midbrain, pons, and medulla. It defines densities seen on CT scans and what they normally indicate or can abnormality show. It outlines the windows of a CT scan and structures seen in each row. It discusses abnormalities that may be observed like hemorrhages, infarcts, tumors, hydrocephalus and atrophy.
CT is the most important imaging modality for evaluating head trauma. It can detect fractures, extra-axial hemorrhages such as epidural hematomas and subdural hematomas, subarachnoid hemorrhage, intraventricular hemorrhage, and intracerebral hemorrhages. Common primary traumatic brain injuries seen on CT include contusions, diffuse axonal injury characterized by small hemorrhages, and deep cerebral and brainstem injuries. MRI can provide additional details, especially in the subacute and chronic stages.
The subarachnoid space is located between the arachnoid membrane and pia mater in the brain. It contains cerebrospinal fluid and spongy connective tissue. Bleeding into this space is called a subarachnoid hemorrhage (SAH), which is often caused by the rupture of an intracranial aneurysm. CT and MRI are used to detect SAH. Treatment involves relieving vasospasm, removing blood, and clipping or coiling the aneurysm to prevent rebleeding. Complications include hydrocephalus, infarction, and herniation. The mortality rate of SAH is 30-60% even after reaching the hospital.
CT scans provide detailed images of brain tissue by measuring tissue density in Hounsfield units. Different tissues have characteristic densities: air is -1000 HU, fat is -70 HU, water is 0 HU, CSF is +8 HU, gray matter is +45 HU, and bone is +1000 HU. CT is useful for identifying acute cerebral infarctions at different stages from hyperacute to chronic based on characteristics such as tissue density and enhancement patterns. Common vascular territories and watershed areas are also identifiable on CT scans.
CT scanning provides images of brain tissue based on density differences detected by x-rays. The images produced use Hounsfield units to represent densities on a scale where air is -1000 and bone is +1000. On CT, white matter appears darker than gray matter and CSF appears black. Common sequences seen on CT include axial, coronal, and sagittal cuts at various anatomical levels. CT is used to identify acute ischemic strokes within 12 hours by detecting hyperdense arteries, and in subsequent days can identify low density infarcts and hemorrhagic transformations. Chronic infarcts appear as well-defined low attenuation areas.
This document provides templates for summarizing various normal and abnormal findings on brain MRI reports. It includes sections for describing a normal brain, abnormalities such as hemorrhage, infarction, space-occupying lesions including tumors, metastases and cysts. Each section lists the key findings to include such as size, location, signal characteristics and enhancement pattern. Post-contrast imaging is discussed where relevant. The aim is to concisely describe the salient radiological findings in a standardized manner.
This document provides information about cerebrovascular disease and brain anatomy as seen on imaging modalities like CT and MRI. It discusses normal brain anatomy, vascular anatomy, and various pathologies like infarctions, hemorrhages, tumors and other lesions. Key points covered include the appearance of acute vs chronic infarctions, differentiation of hemorrhagic vs non-hemorrhagic lesions, venous sinus thrombosis and more. Various imaging findings are illustrated with examples. The document serves as an educational guide for radiologists and neurologists to recognize normal and abnormal brain structures on different scans.
Full story brain herniation imaging Dr Ahmed EsawyAHMED ESAWY
Full story brain herniation imaging Dr Ahmed Esawy
include different cases for oral radiodiagnosis examination all over the world
CT /MRI Plain X ray images
I Supratentorial herniation
1-Cingulate (subfalcine/transfalcine)
2-Uncal (descending transtentorial herniation DTH)
3-Central (bilateral DTH)
4-Transcalvarial
5-Tectal (posterior)
II-Infratentorial herniation
1-Upward
(upward cerebellar or upward transtentorial)
2-Tonsillar (downward cerebellar
III-Sphenoid/alar herniation Transalar Herniation
This document provides an outline on head injury (HI). It discusses the pathophysiology of HI, classification based on Glasgow Coma Scale and mechanism of injury. It describes the components of HI including scalp laceration, skull fractures, and traumatic brain injury. For traumatic brain injury, it covers concussion, contusion, diffuse axonal injury, and intracranial hematomas. It outlines the primary and secondary survey approach for patients with HI, including airway management, breathing, circulation, disability assessment, and exposure.
The blood supply to the central nervous system (CNS), including the brain and spinal cord, is crucial for maintaining the metabolic needs of neural tissues.
Neurosurgical interventions related to the blood supply of the CNS are often aimed at addressing vascular abnormalities, preventing strokes, and managing conditions affecting blood vessels in the brain.
Cavernous Sinus Thrombosis.
This document provides an overview of neurocritical care topics including: common neurologic emergencies like subarachnoid hemorrhage, aneurysms, seizures and tumors; classifications like Hunt and Hess for SAH; monitoring tools like ventriculostomy for ICP; treatments for increased ICP like hyperosmolar therapy; endovascular procedures like coiling; and surgical treatments including craniotomy, clipping and ventricular shunts.
The document discusses diagnostic radiology of the central nervous system. It begins with an outline and overview of normal brain anatomy and imaging features. It then describes basic features seen in common brain lesions including hydrocephalus, brain atrophy, necrosis, calcification, and mass effect. Specific pathologies covered include brain tumors, cerebrovascular diseases like hemorrhage, aneurysms, and infarction, as well as traumatic brain injuries such as epidural and subdural hematomas. Key imaging findings on CT and MRI for various acute and chronic stages are highlighted.
Aneurysmal subarachnoid hemorrhage presentationLe Ky
The document discusses cerebral aneurysms and aneurysmal subarachnoid hemorrhage (SAH). It begins by describing the anatomy of the meninges, which are the three membranes covering the brain and spinal cord. It then defines SAH as bleeding between the brain and its surrounding membrane. The most common cause of non-traumatic SAH is rupture of a cerebral aneurysm, which is a weak spot in the wall of a brain artery. The document discusses risk factors for developing and rupturing an aneurysm. It outlines the clinical features and diagnosis of SAH, including various imaging techniques like CT, CTA, MRA, and catheter angiography. The prognosis is discussed, with about 35% of patients dying
Cerebral venous sinus thrombosis involves blood clots forming in the dural venous sinuses, which drain blood from the brain. It most often affects younger adults and is more common in women. Common risk factors include genetic or acquired prothrombotic conditions, oral contraceptive use, pregnancy, infections, and cancers. Symptoms vary depending on the involved sinus but often include headaches, focal neurological deficits, seizures, and altered mental status. MRI and CT imaging can detect clots and brain abnormalities, while treatment focuses on underlying causes, seizure control, reducing intracranial pressure, and anticoagulation therapy.
2. About this presentation
This presentation will give you a systematic approach
to head CT
By the end you should be familiar with normal
anatomy and be able to identify classic abnormalities
on CT
You can test your knowledge with the short cases at
the end
3. Types of head CT’s
Non-contrast
Contrast
IV contrast is given to better evaluate:
Vascular structures
Tumors
Sites of infection
Relative contraindications:
Allergy, renal failure
4. Common Indications for Head CT
Cranial-facial trauma
Acute stroke
Suspected subarachnoid or intracranial hemorrhage
Evaluation of headache
Evaluation of sensory or motor function loss
Evaluation of sinus cavities
5. CT basics
Before we begin, there are key concepts you should
be familiar with:
Hounsfield units
Windowing & leveling
Planes
6. What’s a Hounsfield Unit?
Named after the inventor of CT
CT scanners record the attenuation (brightness) of each
pixel in Hounsfield Units (HU)
This number represents the relative density of the
scanned substance
Ranges from -1000 to +1000
7. Hounsfield Unit (HU)
Different substances have different relative densities and
thus, different Hounsfield units
Air: -1000 HU
Fat: -50 HU
Water: 0 HU
Soft tissue: +40 HU
Blood: +40-80 HU
Stones: +100 to +400 HU
Bone: +1000 HU
Therefore, if you’re not sure what you’re looking at, measure
its Hounsfield Unit!
8. How to measure HU
In EFILM, you can
measure the HU using
the oval ROI tool:
On the right, you can
see sample
measurements of
different structures
Note how bone, CSF,
brain tissue, and air all
have different mean
HUs
9. Windowing
The human eye can only perceive ~ 16 shades of
gray
The CT scanner records levels of gray far beyond
what the eye can see
Therefore, to interpret images, we have to limit
the number of Hounsfield units shown
(windowing)
The computer then converts this set range of HU
into shades of gray we can see
10. Windows & levels
Window width:
The range of HU of all tissues of interest
Tissues in this range will be displayed in various shades
of gray
Tissues with HU outside the range are displayed as
black or white
Window level:
The central HU of all the numbers in the window width
12. Window examples
In head CT, 3 windows are commonly used
BRAIN window BONE window SUBDURAL window
W:80 L:40 W:2500 L:480 W:350 L:90
13. Plane
Plane refers to how the picture slices are orientated
Transaxial plane
used most often for head CT’s
Coronal plane
good for evaluation of
pituitary/sella and sinuses
Saggital plane
rarely used (more common in
MRI)
15. Identification
Now we can begin our basic approach to the head CT
Start with the easy stuff:
PATIENT NAME (make sure you have the right patient !!)
MEDICAL RECORD # (MRN)
AGE
DATE OF EXAM
16. Previous studies
Always check for any previous scans for comparison
Findings can be very subtle
A good way to spot them is to look for changes between
the current and previous scans
Even old chest and abdominal films can give you clues to
possible brain pathology
ie. Brain mets from lung cancer
17. Study parameters
Make note of the study technique:
Anatomic region of scan: head, neck, spine
Slice thickness (mm)
Window level & width
Plane: Transaxial, coronal, saggital
Use of contrast?
Look for the Circle of Willis. It will be enhanced on studies using
contrast
18. Image analysis
Now that you have noted all the basic information
about the scan, it’s time to look at the scan itself
Use a systematic order & approach to what you look
at
Use the same approach for all scans to ensure that you
don’t miss anything
19. Regions to inspect
We will start from the inside and move outwards:
1. Midline structures & 5. Sulci
symmetry 6. Sinuses
2. Ventricles 7. Bones
3. Cisterns 8. Skin/soft tissue
4. Brain parenchyma
21. Midline shift
Evaluate for midline shift:
The septum
between the
lateral ventricles
should not deviate
more than 5mm
from the midline
Find a slice where the 2 Draw a vertical line down
lateral ventricles are the middle joining the falx
prominent cerebri anteriorly &
posteriorly
22. Midline shift examples
R L R L
A right-sided abscess is causing a A left-sided tumor is causing a
midline shift to the left midline shift to the right
23. 2. Ventricles
Identify:
Lateral ventricles x 2
Third ventricle
Cerebral aqueduct
Fourth ventricle
24. Ventricles
Evaluate for any changes in
Symmetry
Size
Shape
Density
A displaced ventricle is often the product of mass
effect or atrophy
27. Cisterns
Evaluate for any changes in
Symmetry
Size
Density
Cisterns often contain blood with subarachnoid
hemorrhage
Cisterns can fill with pus in the setting of meningitis
30. Brain parenchyma – Deep structures
Lastly, identify the deep structures:
Corpus Callosum
Caudate
Thalamus
Lentiform Nucleus
Internal capsule
External capsule
31. Parenchymal masses
Look for mass lesions
Abscess
Neoplasm
Note how the tumor becomes bright with contrast
Note the ring enhancing lesion consistent
Also note the surroundingof an abscess
with that dark area of edema
32. Acute Infarct
Look for signs of acute infarction
Hyperdense MCA sign Loss of gray-white
differentiation
The middle cerebralto see
Click me artery (MCA) Click me to see
The usual border between grey and white
becomes hyperdense due to occlusion matter is lost due to vasogenic edema
33. Chronic Infarct
Then, look for signs of chronic infarction:
Retractment of parenchyma
from skull due to atrophy
Focal area of
hypodensity
Mild midline shift to the
right due to atrophy
35. Microangiopathic change
You may encounter the term
“microangiopathic change” in reports
and wonder what it is
Microangiopathic change refers to
age-related white matter ischemia due Normal
to microvessel disease
Very commonly seen in the elderly
Its clinical significance is still not
known
Microangiopathic change
36. Types of Hematoma
Look for evidence of a bleed:
Subdural Hematoma
Due to tear of bridging veins
Look for crescentic shape along brain surface
Crosses suture lines
Epidural Hematoma
Due to rupture of middle meningeal artery
Associated with skull fractures
Look for biconvex, lenticular shape
Does not cross suture lines
37. Subdural vs. Epidural
Note the cresentic shape Note the lenticular shape
SUBDURAL EPIDURAL
38. Subarachnoid Hemorrhage
Look for a subarachnoid hemorrhage
Due to aneurysm rupture, trauma, or AVM
Blood in the subarachnoid space and/or ventricles
Blood can often first be seen in the inter-peduncular cistern
Blood in
subarachnoid
space
(Normal)
Blood in
sulci
Blood in ventricle
39. Intraparenchymal Hemorrhage
Look for intraparenchymal
hemorrhage:
blood (acute, subacute, or
chronic) located in brain
parenchyma
surrounding area of edema
may also be seen
Usually caused by
hypertension
40. Hemorrhage timeline
If you see a bleed, try to assess if its new or old:
ACUTE bleed (< 3 days)
Hyperdense (80-100 HU) relative to brain
Caused by protein-Hb component
Can be hard to spot if hemoglobin is low (<80)
SUBACUTE bleed (3-14 days)
Hyperdense, isodense, or hypodense relative to brain
Density loss starts from periphery and goes to centre
CHRONIC bleed (>2 weeks)
Hypodense (<40 HU) relative to brain
41. Density of blood over time in a
subdural hematoma
Hypodense
Hyperdens Isodense blood
e blood blood
Acute Sub-acute Chronic
(<3 days) (3-14 days) (>14 days)
43. Sulci
Remember that sulci will become deeper and more prominent
with age
Look for blood in the sulci & Sylvian Fissure which are
indications of a sub-arachnoid bleed
Acute blood in
Sylvian fissure
Acute blood in
sulci
44. 6. Sinuses
Switch to Bone Window to better evaluate the sinuses
Identify:
Superior Saggital Sinus
Frontal Sinus
Ethmoid Sinus
Sphenoid Sinus
Maxillary Sinus
51. Recap
Begin with the basic identification
Remember to check for previous scans
Check the technique
Look at each region of the brain systematically
We started from the middle and worked out:
1. Midline structures 5. Sulci
2. Ventricles 6. Sinuses
3. Cisterns 7. Bones
4. Brain parenchyma 8. Skin/soft tissue
52. Recap
In each area, identify the major anatomy
Then look for findings
Below is a list of important things not to miss:
Midline: midline shift
Ventricles: blood and mass effect
Cisterns: blood and pus
Parenchyma: signs of ischemia and/or bleeding
Sulci: for blood
Sinuses: signs of sinusitis
Bones: fractures
Soft tissue: hematoma
53. Recap
Remember to use the same approach every time so
that you don’t miss anything!
Try out the cases in the next slides to test your
knowledge
54.
55. Case #1
Mr A is an 80 y/o female presenting with:
Expressive aphasia/apraxia
Mild right facial droop
Atrial fibrillation
A non-contrast CT scan of her brain is performed
56.
57. Your analysis
What are your findings?
What is your impression?
What would be your top diagnosis?
59. Case #1 - Answer
Mr A had an infarction of her Left
Parietal Lobe
The location is consistent with
MCA infarction
The cause was emboli related to
her atrial fibrillation
60. Case #2
Mr. B is a 56 y/o male presenting with:
A sudden onset 10/10 headache while running
Photophobia, nausea & vomiting
No history of trauma or LOC
Otherwise well
A non-contrast CT scan of his brain is performed
61.
62. Your analysis
What are your findings?
What is your impression?
What would be your top diagnosis?
Is this pathology acute, subacute, or chronic
63. Case #2 - Answer
Mr. B had a large subarachnoid
hemorrhage
The bleed was acute
This was caused by rupture of an
ACA aneurysm
He was admitted to ICU where
his condition deteriorated
rapidly
He passed away shortly after
admission
64. Case #3
Mr C is a 66 y/o female who slipped down the stairs
yesterday and hit the back of her head.
She presents with
Generalized left sided weakness
Light headache
A non-contrast CT scan of her brain is performed
66. Your analysis
What are your findings?
What is your impression?
What would be your top diagnosis?
Is this pathology acute, subacute, or chronic
67. Case #3 - Answer
Mr C had a large right-
sided subdural hematoma
The hematoma is acute
This was caused by
rupture of bridging veins
when she hit her head
A craniotomy was
performed and the bleed
was drained
68. Bonus case
Mr. X is a 80 y/o male presenting with:
3 month history of delirium
Recent fall from bed
Large scalp laceration
No focal neurological findings
An non-contrast CT scan of his brain is performed
70. Analysis
Can you spot the abnormalities?
What is your impression?
What would be your top diagnosis?
71. Bonus case - Answer
Mr. X had a tiny right-sided
subdural hematoma
Blood is seen along the left
subdural space as well as in the
falx cerebri anteriorly (arrows)
The hematoma is acute
Because of its small size, no
immediate treatment was
required
Follow-up CT scans showed
resolution of the subdural
hematoma
Normal scan for comparison