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Interpretacion de TAC de CRÁNEO fase simple

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DIANA AMÉRICA CHÁVEZ CABRERA
IMAGENOLOGIA-NEUROLOGIA
INTERPRETACIÓN TAC CRÁNEO FASE SIMPLE
DR. ALEJANDRO SCHELESKE
DR. DAVID REYES ROSAS

Published in: Health & Medicine, Travel
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Interpretacion de TAC de CRÁNEO fase simple

  1. 1.  La TAC simple de cráneo no requiere de preparación previa.  INMOVILIZACIÓN: evitar que el estudio salga «rotado», mejor calidad de imágenes.  Retirar objetos metálicos: joyas, anteojos, prótesis dentales etc. para evitar obstrucción de las imágenes.  Duración del examen 5-10 minutos.
  2. 2.  Déficit neurológico agudo (pérdida estado de conciencia, sensibilidad, motilidad) ya sea focalizado o generalizado  Asociado a cefalea de inicio agudo de elevada intensidad, enfermedades efecto de masa…  Estudio de elección en TCE (pérdida de la conciencia >5 min.)  Altamente sensibles para detectar hemorragias, EVC (48 hrs), HSA, hidrocefalia.  Como un estudio de control, sobre todo en anomalías congénitas.  Contrastada: Neuroinfección, detección tumores y EM.
  3. 3.  Herniación transtentorial  Hematoma epidural  Hematoma subdural  Hematoma Intracerebral  Contusión hemorrágica  Hemorragia Intraventricular  HSA  Neumoencéfalo  Edema  Desviación de línea media
  4. 4. (Musc. Occipitofrontal)
  5. 5. Hematoma subgaleal Hematoma epidural
  6. 6. Temporal Occipitofrontal Vientre frontal Gálea aponeurótica Vientre occipital
  7. 7. Masetero Temporal
  8. 8.  Frontal  Etmoides  Esfenoides  Temporales  Occipital  Parietales
  9. 9. Separa el cerebelo de los hemisferios cerebrales Permite el paso del tallo de la hipófisis Separa los hemisferios cerebrales Permite paso del mesencéfalo Separa los hemisferios del cerebelo Separa los hemisferios cerebrales
  10. 10. Infratentoriales Supratentoriales
  11. 11. DURAMADRE PARIETAL ARACNOIDES PIAMADRE Hematoma epidural (A. meningeas) Hematoma subdural •LCR •HSA Espacio subaracnoideo: DURAMADRE VISCERAL
  12. 12. Hematomas epidurales
  13. 13. Cerebro propiamente dicho Prosencéfalo (hemisferios cerebrales) Diencéfalo Tronco encefálico Mesencéfalo Protuberancia (Puente) Bulbo raquídeo Cerebelo
  14. 14. Valle silviano
  15. 15. Posterior cerebral Vertebrobasilar Base
  16. 16. • Microaneurismas de Charcot Bouchard: hemorragias intraparenquimatosas • Microateromas: infartos lacunares
  17. 17. Seno recto Seno longitudinal Cisterna magna o confluencia de los senos Seno transverso Seno sigmoideo
  18. 18. Cresta frontal Protuberancia occipital Septum pellucidum
  19. 19. LOBULO FRONTAL TEMPORAL TEMPO LOBULO OCCIPITAL
  20. 20. LOBULO PARIETAL LOBULO FRONTAL LOBULO OCCIPITAL LOBULO PARIETAL
  21. 21.  Integridad del hueso  Para una mejor evaluación, se solicita una ventana ósea  Hallazgos normales  Calcificaciones:  Glándula pineal (jóvenes)  Cuerpos coroideos  Hoz del cerebro (ancianos)
  22. 22.  Edad  Grado de atrofia: Circunvoluciones adelgazan y los cisuras se ensanchan  Simetría de las estructuras  Exploración bilateral Atrofia cortical Masculino de 85 años Otras enfermedades causantes de atrofia: Encefalopatía por VIH, Meningitis primaria, Toxicomanías y alcoholismo crónico, terapia prolongada con esteroides
  23. 23.  ¿Centrada o rotada?  Hay desplazamiento de línea media? TAC contrastada
  24. 24. 1. Trazar una línea central (de la cresta frontal hacia la protuberancia occipital) 2. Trazar una línea imaginaria que atraviese las estructuras centrales: hoz del cerebro, septum pellucidum… 3. Medir la distancia entre ellas en el punto más distante 4. Compararla con la escala
  25. 25.  Densidades:  Sustancia blanca más hipodensa que la sustancia gris  Checar densidad de los ganglios basales  Zona frecuente de patología: aneurismas, infartos lacunares…  Integridad y tamaño del sistema ventricular  Incrementa en hidrocefalia y atrofia  Disminuye en edema del parénquima Edema generalizado en tras una intoxicación de extasis en un masculino de 23 años Obsérvese la pérdida de la relación sustancia gris-blanca

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