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Introduction To Head Ct Imaging PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Introduction to Head CT Imaging” by Ryan Hakimi, DO, MS.

This medical PowerPoint presentation is about head CT imaging, a non-invasive medical procedure that uses a computerized tomography (CT) scanner to create detailed images of the brain, skull, and surrounding tissues. The images produced by a head CT can help doctors diagnose a wide range of medical conditions, including traumatic brain injuries, tumors, infections, and other abnormalities.

During a head CT scan, the patient lies flat on a table and moves through a doughnut-shaped scanner. X-ray beams are directed through the patients head, and detectors on the opposite side of the scanner pick up the signals that have passed through the body. These signals are then sent to a computer, which uses advanced algorithms to reconstruct the images of the head and brain.

The images produced by a head CT scan can provide valuable information about the structure and function of the brain, as well as the presence of any abnormalities or injuries. This information can help doctors make accurate diagnoses and develop appropriate treatment plans for their patients.

Head CT imaging is generally considered safe and non-invasive, but it does involve exposure to a small amount of ionizing radiation. The risk of radiation exposure is generally very low, and the benefits of a head CT scan usually outweigh any potential risks. However, patients should always talk to their doctor about any concerns they may have about the procedure.

Tags : Head CT Imaging, non-invasive medical procedure, computerized tomography, brain, skull, traumatic brain injuries, Neurology, Neurology PowerPoint presentation

Published on : Jun 20, 2023 | Views : 2496 | Downloads : 6

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Slide 1-

Introduction to Head CT Imaging Ryan Hakimi, DO, MS Assistant Professor Director, Critical Care Neurology Emmaculate Fields, APRN-CNP Clinical Instructor Department of Neurology The University of Oklahoma Health Sciences Center
Slide 2-

DISCLOSURES FINANCIAL DISCLOSURE Nothing to disclose UNLABELED/UNAPPROVED USES DISCLOSURE Nothing to disclose Some slides have been adapted from teaching modules at OU, UIC, and NSA
Slide 3-

LEARNING OBJECTIVES Upon completion of this course, participants will be able to: Understand the basics of head CT imaging Identify and describe basic cerebral anatomy Develop an approach to head CT interpretation Identify pathologic lesions found on head CT
Slide 4-

CT BASICS CT uses x-rays Provides axial brain view CT scan measures density of the tissue being studied
Slide 5-

CT Brain axial view CT uses x-rays to make cross-sectional axial images Right is on left and left is on the right Patient lying on a stretcher with feet coming toward you and is slid through a large open ring (CT machine) Lateral view of skull is shown with imaging planes indicated by lines. The true horizontal plane is approximated by the orbitomeatal line, while the typical CT imaging plane is angled slightly upward anteriorly
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CT BASICS-density Black White
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Hyperdense things on CT
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Isodense things on CT Note that white matter is less dense than gray matter and therefore: white matter is darker than gray matter Gray matter (cerebral cortex) Gray matter (basal ganglia) White matter
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Hypodense things on CT
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Sella turcica (contains pituitary gland) Petrous bone Mastoid air cells Pons 4th ventricle Cerebellum Eye Optic nerve Sphenoid bone Temporal lobe Normal Brain anatomy
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Normal Brain Anatomy Frontal lobe Interhemispheric fissure Sylvian fissure Middle cerebral artery Temporal lobe Lateral ventricle (temporal horn) Suprasellar cistern Perimesencephalic cistern Midbrain Quadrigeminal plate cistern Cerebellum (vermis) Occipital lobe
Slide 12-

Normal Brain Anatomy Lateral ventricle (frontal horn) Frontal lobe Caudate nucleus (head) Sylvian fissure Insula (cortex) Lentiform nucleus Internal capsule (post. limb) Thalamus Pineal gland (calcified) Choroid plexus (calcified) Occipital lobe
Slide 13-

Approach to Reading a CT scan- ABBBC A- Air-filled structures (sinuses, mastoid air cells) B- Bones (fractures) B- Blood (subarachnoid, intracerebral, subdural, epidural hematoma) B- Brain tissue (infarction, edema, masses, brain shift C- CSF spaces (sulci, ventricles, cisterns, hydrocephalus, atrophy)
Slide 14-

A- Air-filled Structures Normal air spaces are black both on bone and brain window (frontal, maxillary, ethmoid, and sphenoid sinuses) Mastoids are spongy bone filled with tiny pockets of air When these pockets are opacified you will see a (gray or white) shade Air-fluid levels in the setting of trauma suggest a fracture Mastoid opacification without trauma indicates mastoiditis
Slide 15-

B- Bones Useful when trauma is suspected Window your image for bone reading Recognize normal suture structures (usually visible on both sides) If fracture suspected, inspect the opposite side for similar finding If not present then look for abnormalities associated with the fracture (air/pneumocephalus, black spots within the hemorrhage)
Slide 16-

B- Blood Location and shape of the blood Epidural hematoma: over brain convexity, not crossing suture line, lens shaped (biconvex). Subdural hematoma: over brain convexity, interhemispheric, along the tentorium, SDH will cross suture lines & it’s crescent shaped. Intraparenchymal/Intracerebral hemorrhage: within the brain matter, sizes/shape varies dependent on etiology can be regular or irregular. Interventricular hemorrhage- inside ventricles, can be isolated and or secondary to SAH, ICH. Subarachnoid hemorrhage- blood within the subarachnoid spaces (sulci, sylvian fissure, cisterns). Usually assumes shape of the surrounding cerebral structure Types of Intracranial Hemorrhage
Slide 17-

Epidural Hematoma 20% will have a lucid period before clinical worsening Note the soft tissue swelling adjacent to the hematoma explaining the mechanism of the injury E
Slide 18-

Epidural Hematoma Arterial injury following head trauma Lens shaped Confined between the sutures Most commonly middle meningeal artery
Slide 19-

Epidural Hematoma Repeat CT brain (post-op)
Slide 20-

Subdural Hematoma (SDH) Differentiate between acute, subacute, chronic, or acute on chronic Acute SDH Bright white on CT Can only be removed with a craniotomy Doesn’t always require surgery, depends on the patient’s neurological examination and comorbidities Usually related to shearing of bridging veins between the dura and brain
Slide 21-

Acute Subdural Hematoma
Slide 22-

Acute and Chronic Subdural Hematoma Patient may be asymptomatic until the event leading to the acute component Chronic component can be drained using a bedside burr hole device such as the Subdural Evacuation Port System (SEPS) http://www.hakeem-sy.com/main/files/subdural%20hematoma.jpg, accessed on 3/31/10
Slide 23-

ICH: Sites of Spontaneous ICH
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Slide 25-

Calculating the ICH Volume A X B X C 4 For standard 0.5 cm slices:
Slide 26-

Predictor of Outcome
Slide 27-

Traumatic Intracerebral hemorrhage Occurs at the time of impact Diffuse axonal injury Inertial forces cause deformation of the white matter, aka shear injuries Most commonly leads to acute coma CT (not very sensitive) may reveal petechial hemorrhages in the central 1/3 of the brain (subcortical white matter, corpus collosum, basal ganglia, brainstem, cerebellum) MRI to evaluate extent of injury Gennarelli, et al J. Trauma 1994
Slide 28-

Traumatic Intracerebral hemorrhage Focal parenchymal contusions Coup, contra coup, intermediate coup CT: hemorrhagic core surrounded by low density edema Variable CBF in and around contusion
Slide 29-

Intraventricular Hemorrhage Variety of etiologies Anticoagulation Hypertension Aneurysm Substance abuse Trauma (less likely) Often will need an external ventricular drain with or without intraventricular tPA http://www.bing.com/image, accessed 6/12/14
Slide 30-

Subarachnoid Hemorrhage Always exclude an aneurysm even when head trauma is obvious Aneurysmal SAH has a poorer prognosis than traumatic subarachnoid hemorrhage Traumatic subarachnoid hemorrhage Serially monitor the patient clinically Rarely required surgical intervention Usually has a good prognosis
Slide 31-

Practice Reading CT scans-ABBBCBrain tissue In 1st few hours to day, CT usually normal (though may show blurring of gray-white junction & sulcal effacement as seen on next slide) By day 2, CT shows dark area with mass effect (compression of surrounding structures) Day 3 Subacute infarction Day 1 Acute infarction A B
Slide 32-

Figure 1. A, Normal anatomy; B, tonsillar herniation; C, uncal and subfalcine herniation; and D, central herniation. By permission of Mayo Foundation for Medical Education and Research. All rights reserved. Catastrophic Neurologic Disorders in the Emergency Department. 2nd ed. New York: Oxford University Press; 2004:67–69. Herniation Syndromes
Slide 33-

Practice Reading CT scans-ABBBCAir filled structures A: Left parietoocipital pneumocephalus post-op B: Left temporal ICH C: Left sinus air fluid level with associated sinus fracture A B C
Slide 34-

Thank you