Upload
eric-manning
View
214
Download
0
Tags:
Embed Size (px)
Citation preview
Erin O’Connor
NEURORADIOLOGY TRAUMA WORKSHOP
LEARNING OBJECTIVES
• Know the appropriate imaging work up for patients with head trauma.
• Recognize the appearance of intracranial hemorrhage on CT, specifically epidural, subdural, subarachnoid and intraparenchymal hemorrhage.
• Describe the various types and causes of brain herniation.
• Recognize the typical changes in appearance of intracranial blood products with age on CT
• See the typical appearance of diffuse axonal injury on MRI and CT
• List criteria that are used in spinal trauma to determine if the patient should have CT of the cervical spine.
• Describe some of the traumatic injuries than can be seen on a lateral c-spine radiograph
TRAUMA TO THE HEAD
• What imaging modality would you use?
• What are you looking for?
• Why not use MRI is setting acute trauma to head?
BRAIN CONTUSIONS
• What are they?
• Where do they typically occur?
Figure 9. Acute trauma in a 17-year-old pregnant girl after a rollover motor vehicle accident in which she lost consciousness.
Goldman S M , Wagner L K Radiographics 1999;19:1349-1357
©1999 by Radiological Society of North America
DIFFUSE AXONAL INJURY
• What is it? How do patients get it?
• Describe the clinical picture of DAI?
• Where does it occur?
• What is the best way to detect it on imaging?
TRAUMA TO THE NECK
• What imaging modality would you use?
• What are you looking for?
NORMAL CT CERVICAL SPINE
NORMAL CT CERVICAL SPINE
NORMAL CT CERVICAL SPINE
• Medrol 32 mg po (or its equivalent) 12 and 2 hours prior to contrast administration.
• Some also give benadryl at time of contrast adminstration
• Cardiac pacemakers, insulin pumps, neurostimulators, cochlear implants
• Non-graphite spinal cord tongs: Graphite tongs are compatible.
• Thermodilution Swan-Ganz catheter: Local heating can result.
• Metal outside the brain and eye is NOT a contraindication: Cardiac valves, inferior vena cava filters, biliary and vascular stents, IUD's and metallic prostheses are safe, unless doubt as to positional stability.
• Plain radiography sufficient for screening.
BUT WHAT IF…
CONTRAINDICATIONS TO MRIKNOWN ALLERGIES TO CONTRAST