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Intro to Head CT
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Intro to Head CT
Renee B. Van Stavern, MD
Neurology
Normal head CT
Back
Front
Slice
thickness
Bone
Muscle
Hemorrhage
Contrast
Brain
Grey matter
White matter
Edema
CSF
Fat
Air
Attenuation
CT bone windows
CT Contrast
CT Contrast
Kindergarten Kop – It’s NOT a tuma. B. Mendelson
CT Advantages
Fast
Available
(Relatively) inexpensive
Sensitive for intracranial hemorrhage
CT Limitations
There is radiation
Bone artifact obscures visualization, especially
posterior fossa and spinal cord
Not very sensitive to intraparenchymal lesions or
brain edema
Noncontrast CT misses many abnormalities
Risk of allergic reaction to iodinated contrast media
http://www.radiology.wisc.edu/Med_Students/neuroradiology/NeuroRad/NeuroRad.htm
Cingulate gyrus
Brain Anatomy Review
The anatomic origin of the foot fetish. K. Clark
Major brainstem divisions 1 2 3
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Diencephalon
http://www9.biostr.washington.edu/
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3 4 5
http://www9.biostr.washington.edu/
Ventricular system
1 2 3
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6 7 8
http://www9.biostr.washington.edu/
1 2 3 4
5
http://www.radiology.wisc.edu/Med_Students/neuroradiology/NeuroRad/NeuroRad.htm
Normal anatomy
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Note Brainstem Orientation!
CT Neuroanatomy Class
WU Neuroscience Tutorial
http://thalamus.wustl.edu/course/
Dorsal
Ventral
Ventral
Dorsal
http://medstat.med.utah.edu/kw/brain_atlas/brsc 1
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http://medstat.med.utah.edu/kw/brain_atlas/brsc/index.htm
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Creepy two eyes and a smiling face – C. Sumey
http://medstat.med.utah.edu/kw/brain_atlas/brsc/index.htm
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A calcified, ciliated, CSF-producing mucosal structure. C. Hou
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Arteries
1 2 3 4 5 6
7 8 9 10 11
Abnormal head CT
An order for reading scans
Patient, type of scan, indication, level
Quality of scan
Cranial and extracranial structures
(White spaces)
Ventricles, cisterns, and sulci
(Black spaces)
Brain parenchyma
Hemorrhage
Lesions
Describe lesions
Location
Density
Margins
Effects
Associated findings
Temporal progression
Differential diagnosis
Increased CT brain
attenuation
Hemorrhage (acute)
Calcium
Contrast
Metal
Decreased CT brain
attenuation
Ischemia
Infection
Neoplasm
Trauma
Edema
Hemorrhage (old)
Recommended