The document provides steps for reading a CT scan of the head, including: 1. Identifying that the images are of a head CT scan 2. Determining if the scan was done with or without contrast 3. Checking patient identity and scan details 4. Reading the scan from outer to inner layers and checking for injuries like hematomas, fractures, edema, and more.

1. CARA BACA CT SCAN

2. Langkah membaca CT SCAN kepala
yang harus diperhatikan:
1. Pastikan Foto yang akan dibaca adalah Foto CT Scan kepala (bone
W/brain W)
2. Menentukan CT Scan dengan atau tanpa kontras, biasanya kasus
cedera kepala tanpa kontras.
3. Menentukan dengan tepat identitas pasien,diagnosa, jam dan
tanggal pembuatan sesuai dengan tanggal dan tempat pemeriksaan

3. Langkah berikutnya
1. Membaca CT Scan dari lapisan luar kepala menuju ke lapisan dalam,
Scalp→ Tulang → parenkim.
2. Pada pembacaan Scalp, mencari adanya chephal hematom.
3. Pada pembacaan Tulang, mencari adanya tanda fraktur, impresi atau
linier, bedakan dengan garis sutura yang ada.

4. 4. Pada pembacaan parenkim, mencari adanya perdarahan epidural,
subdural, contusional,
• intraserebral, intraventrikel, hidrochepalus.
• (Pada pengukuran adanya perdarahan, yang diperhatikan adalah
ketebalan hematom pada slice
• yang paling tebal, pengukuran volume= (jumlah slice x tebal x
panjang) : 2
• semua ukuran dalam cm, yang di foto CT Scan biasanya mm,
dikonversi menjadi cm.
• Pergeseran/midline Shift dapat dihitung dengan menarik garis lurus
dari crista galli ke Protuberansia
• oksipitalis interna, tegak lurus dengan septum pellucidum.)

8. 5. Mencari tanda patah tulang basis, terlihat dari adanya fraktur pada
os.sphenoid, os.petrosa,os.paranasalis dan perdarahan sinus.
6. Menetukan tanda edema otak, dapat terlihat dari adanya 3 hal yaitu:
• 1. melihat sistem ventrikel yang ada
• 2. melihat sistem sisterna, terutama sisterna basalis
• 3. melihat adanya perbedaan lapisan white matter dan grey
matter
7. Kesimpulan hasil pembacan, disebutkan dari yang paling memiliki
arti klinis penting diikuti oleh hal

11. EPIDURAL HEMATOMA
• (Mild Head Injury + EDH at right frontal + Closed depressed fracture
>1 table at right frontal)
• Soft tissue swelling at right frontal
• Bone discontinuity > 1 table at right frontal
• Sulcus and gyrus are not compressed
• Sylvian fissure & cisterns are not compressed
• Ventricles are not compressed
• Hyperdense mass biconvex at right frontal, with volume + 5 cc
• Midline shift (-)

12. CT Scan Kepala Non Kontras di RS Hasan Sadikin, Bandung
14 April, 2020

13. CT Scan Kepala Non Kontras di RS Hasan Sadikin, Bandung
14 April, 2020
• Pembengkakan jaringan lunak
pada temporal sinistra
• Diskontinuitas tulang pada
temporal sinistra
• Sulkus dan girus terkompresi
• Sylvian fissure terkompresi
• Ventrikel terkompresi
• Sisterna tidak terkompresi
• Lesi hiperdens bikonveks di
temporal sinistra dengan volume
25 cc
• Lesi hipodens pada frontoparietal
sinistra
• Midline shift (-)

14. Non-Contrast Head CT Scan, RSHS, 22/05/2015
14

15. Non-Contrast Head CT Scan, RSHS, 22/05/2015
15
• Soft tissue swelling at left
frontal, temporal
• Bone discontinuity at left
temporal
• Hyperdense mass,
biconvex, at left
frontotemporoparietal,
volume 45 cc
• Sulci and gyri, sylvian
fissure, cerebral cisterns
compressed
• Midline shift >5mm to the
right

16. Non-contrast Head CT-scan, Santo Yusuf,
30/04/2015
16

17. Non-contrast Head CT-scan, Santo Yusuf,
30/04/2015
17
• Soft tissue swelling at
left frontal
• Bone discontinuity at
left frontal
• Hyperdense mass,
biconvex, left
frontotemporal, volume
51 cc
• Sulci and gyri, sylvian
fissure, cerebral
cisterns compressed

18. Non contrast Head CT scan Budi kartini Hospital
19th July 2015

19. Non contrast Head CT scan Budi Kartini Hospital
19th July 2015
• Soft tissue swelling at right frontal
• Bone discontinuity(+) at right temporal
• Sulcy and gyri are compressed
• Sylfian fissure are compressed
• Ventricle and cisterna are compressed
• Hypoyhyperdense mass biconvex at
right Temporoparietal Vol:43cc
• Midline shift <5mm to the left

20. SUBDURAL HEMATOMA
• (Severe Head Injury + SDH at right frontotemporoparietal + Closed linier
fracture at right parietooccipital and left parietal + Fracture of costae 5th-8th
right posterior aspect + OS Corneal Cicatrix)
• Soft tissue swelling at right temporoparietooccipital to midoccipital
• Bone discontinuity at right parietooccipital and left parietal
• Sulcus and gyrus are compressed
• Sylvian fissure & cisterns are compressed
• Ventricles are compressed
• Hyperdense mass crescent shape at right frontotemporoparietal with
thickness > 10 mm
• Midline shift (+) > 5 mm to the left

21. Non-Contrast Head CT Scan, Immanuel hosp,
16/05/2015
21
• Soft tissue swelling at right
frontal, left parietooccipital
• No bone discontinuity
• Hyperdense mass at right
frontotemporal
• Hyperdense mass, crescent
shape, right
frontotemporoparietal,
thickness >1cm
• Hyperdense shadow (+)
• Sulci and gyri, sylvian fissure,
cerebral cisterns compressed
• Midline shift >5mm to the
left

22. SUBARACHNOID HEMATOMA
• (Moderate Head Injury + SDH at Right Frontotemporal et Left Frontoparietal + Contusio
Cerebri at Right Frontal + Traumatic SAB)
• Soft tissue swelling at left parietal
• No bone discontinuity
• Sulci and gyri are compressed
• Sylvian fissure are compressed
• Ventricle and cystern are compressed
• Hyperdense mass cresent shape at right frontotemporal with thickness < 1 cm
• Hyperdens mass cresent shape at left frontoparietal with thickness < 1 cm
• Salt and pepper appearance at right frontal
• Hyperdens shadow (+)
• Midline shift (+) < 5mm to the left

23. INTRACEREBRAL HEMORRHAGE
• (Acute communicating hydrocephalus due to Spontaneous ICH at Right Thalamus + IVH due to Susp.
Hypertension + Emergency Hypertension + Pulmonary Edema + AKI stage 1)
• Sulcus and gyrus are compressed
• Sylvian fissures are not compressed
• Cisterns are compressed
• Enlargement of all ventricles
• TH > 2 mm
• FH/ID 40%
• Evans ratio 0,32
• Hyperdense mass at right thalamus with volume + 3 cc
• Hyperdense lesion at all ventricles
• Periventricular edema (+)
• Midline shift (-)
• ICH score 2

25. CT Scan Kepala Tanpa Kontras di RS Bayu Asih
22 Juni 2015

26. CT Scan Kepala Tanpa Kontras
di RS Bayu Asih
22 Juni 2015
• Pembengkakan jaringan lunak (+) a/r
temporooccipital dekstra
• Diskontinuitas tulang (+) occipital dekstra
• Sylvian fissure terkompresi
• Ventricle and Cysterna terkompresi
• Sulcus & gyrus terkompresi
• Massa hiperdens a/r temporoparietal dekstra,
18 cc
• Massa hiperdens crescent shape a/r
frontotemporoparietoocciptal dekstra,
ketebalan <1 cm
• Midline shift > 5 mm ke arah kiri

27. Non Contrast Head CT Scan at Hasan Sadikin Hospital, Bandung
April 24th 2020
• Sulci and gyri are compressed
• Sylvian fissure are compressed
• Cistern are not compressed
• ventricle are compressed
• Hyperdense lesion at left
putamen and external capsule
with volume 30 cc
• Midline Shift (+) > 5 mm to the
right
• ICH Score = 2

28. INTRAVENTRICULAR HEMORRHAGE
• (Spontaneous IVH due to susp. Hypertension DD/ Ruptured aneurysm +
Hypertension stage 1)
• Sulcus and gyrus are not compressed
• Sylvian fissure & cisterns are not compressed
• Enlargement of all ventricles
• TH > 2 mm
• FH/ID : 32%
• Evan’s ratio : 0,26
• Hyperdense lesion at all ventricles
• Midline shift (-)
• ICH score 1

30. TERIMA KASIH

31. Non Contrast Head CT Scan at Hasan Sadikin Hospital
March 22nd, 2020

32. • Soft tissue swelling (+) at bifrontal
• Bone discontinuity (+) depressed >
1 tabula at bifrontal
• Sulci and gyri are not compressed
• Sylvian Fissure are not
compressed
• Ventricle and cisterns are not
compressed
• Hypodense lesion at bifrontal,
volume ± 3 cc
• Salt and pepper appearance at
right frontal
• Midline shift (-)
Non Contrast Head CT Scan at Hasan Sadikin Hospital
March 22nd, 2020

33. DK/ Moderate Head Injury (perbaikan) + Open Fracture depressed > 1
tabula at bifrontal + Pneumocephalus at bifrontal + EDH at temporal
sinistra + Cerebral contusion at Right Frontal + SBF Anterior
ICD 10:Concussion (S06.0); Unspecified open fracture of skull (S02.91XB); Other
specified disorders of brain (G93.89); Epidural Hemorrhage (S06.4);
Contusion and laceration of cerebrum (S06.339A); Fracture of base of
skull (S02.109A)
Th/ Craniectomy debridement and cranialization
ICD 9: Craniectomy (01.25)
GCS this morning : 15 RR OK

36. MORE INFO
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TITLE #2
Lorem Ipsum is simply dummy text of the printing and typesetting
industry. Lorem Ipsum has been the industry's standard dummy
text ever since the 1500s, when an unknown printer took a galley
of type and scrambled it to make a type specimen book. It has
survived not only five centuries, but also the leap into electronic
typesetting, remaining essentially unchanged. It was popularised in
the 1960s with