Introduction to head ct

http://www.med-ed.virginia.edu/courses/rad/headct/index.html

Acute subdural

Acute

Acute subdural

Extradural = epidural

haematoma with midline shift

Limited by

sutures

http://quizlet.com/40218512/rapid-review-pathology-chapter-26-nervous-system-and-special-sensory-disorders-images-flash-cards/

Chronic Subdural (weeks)

Subacute subdural

(days to weeks)

Extra dural on the patient’s right

Traumatic subarachnoid blood on the patient’s left (probable contra coup)

Spontaneous subarachnoid bleed ,

probably from aneurysm.

Get a CT angiogram while they are still in

CT

Intraventricular haemorrhage

Usually secondary to

hypertension

Other causes eg bleed into a

metatasis

Ring enhancing lesion

Ring enhancing lesions

MAGIC DR L

M: metastasisA: abscess

immunocompetent – usually bacterial direct head and neck vshaemotogenousImmunocompromised – toxoplasmosis, listeria, nocardia, aspergillusTravel Hx

G: glioblastoma multiformeI: infarct (subacute phase)C: contusionD: demyelinating diseaseR: radiation necrosis or resolving haematomaL: Lymphoma

Search for the source

Old lacunar infarct

eg thalamus, pons, internal capsule

Sensory and or motor deficits but no

change in LOC or comprehension

Day old cortical

ischaemic stroke

Eg whole MCA territory, dense paralysis and loss of sensation,

decreased LOC and comprehension

General care of the

acute head

Find the cause eg emboliTreat the cause eg infective, immunocompromise

NBM30 degrees head up

NormoxiaNormocapnia

Maintain hydrationLower BP if extreme (see next slides)

Exclude urinary retentionAvoid pressure areas

Hypertonic saline, bicarb or mannitol if coning and heading to theatre