DR A GAZDAR04/09 /2013

Interpretation of CT Brain- neuro

surgical prospective

CT

Sliced angled images of brain from skull base to vertex.

Either cross sectional (axial) / coronal / sagittal images

Radiocontrast used is iodinated : !!!allergy

Normal anatomyA. Frontal LobeB. Frontal Bone

(Superior Surface of Orbital Part)

C. Dorsum SellaeD. Basilar ArteryE. Temporal LobeF. Mastoid Air CellsG. Cerebellar

Hemisphere

A. Frontal LobeB. Sylvian FissureC. Temporal LobeD. Suprasellar

CisternE. MidbrainF. Fourth VentricleG. Cerebellar

Hemisphere

A. Falx CerebriB. Frontal LobeC. Anterior Horn of

Lateral VentricleD. Third VentricleE. Quadrigeminal

Plate CisternF. Cerebellum

A. Anterior Horn of the Lateral Ventricle

B. Caudate NucleusC. Anterior Limb of the

Internal CapsuleD. Putamen and Globus

PallidusE. Posterior Limb of the

Internal CapsuleF. Third VentricleG. Quadrigeminal Plate

CisternH. Cerebellar VermisI. Occipital Lobe

A. Genu of the Corpus Callosum

B. Anterior Horn of the Lateral Ventricle

C. Internal CapsuleD. ThalamusE. Pineal GlandF. Choroid PlexusG. Straight Sinus

A. Falx CerebriB. Frontal LobeC. Body of the Lateral

VentricleD. Splenium of the

Corpus CallosumE. Parietal LobeF. Occipital LobeG. Superior Sagittal

Sinus

A. Falx CerebriB. SulcusC. GyrusD. Superior Sagittal

Sinus

Trauma

Both brain and bone windows need to be examined

Fractures are noted in sinuses, skull base, mastoid bone, temporal (petrous), skull.

Either linear or depressed.Either displaced or

undisplaced

SAHMost commonly

associated with vascular anomalies

Aneurysm, AVMCT grading is

Fischer grade

Acute SDHNSx emergencyCrescent shapedHyperdense, may

contain hypodense foci due to serum, CSF or active bleeding

Does not cross dural reflections

EDHAssociated with skull

fracturesHyerdense biconvexCan cross the dural

borders

contusionsill-defined hypodense area

mixed with foci of hemorrhage.

Adjacent subarachnoid hemorrhage is common.

>24-48 hours, hemorrhagic transformation or coalescence of petechial hemorrhages : evolution

tumorsContrast needed to

delineateMultiple at grey white

junction– metsDural based –

meningiomaDiffuse

intraparenchymal – high grade gliomas

hydrocephalousCommunicating or

obstructiveTrapped hornsLook for causeAssociated hardware

Intracranial infections

Abscess – extra or intra cranial

Extra : look for sinusitis, thrombophlebitis, postop

Intra: look for distant source

Nerve wreck…..Describe the lesion…

Fischer grade for SAH in image

Please describe the pathology..

Thank you..

Have a great day!!