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CT Head Flashcards

(41 cards)

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1
Q

What are the Indications for CT head scan?

A
  • Gcs 13 or less
  • vomiting
  • post traumatic seizures
  • suspected depressed/open fracture
  • Use or anti-coagulants
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2
Q

What is hydrocephalus?

A

-dilation of the cerebral ventricular system.

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3
Q

What does hydrocephalus look like on images?

A
  • dilated ventricle (x sign)
  • surrounding oedema
  • small sulci
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4
Q

What causes hydrocephalus?

A
  • overproduction of CSF
  • failure of reabsorption of CSF
  • Obstruction of the flow of CSF
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5
Q

Where is CSF produced, where does it travel and what does it do?

A
  • produced in cells in choroid plexus
  • moved from ventricles to subarachnoid space
  • bathed the brain and spinal cord
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6
Q

What is CSF absorbed?

A

-CSF is absorbed by arachnoid granules in the walls of venous sinuses.

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7
Q

What causes the failure of reabsorption of CSF?

A
  • choroid plexus tumour pressing on aqueduct of Sylvius
  • midbrain tumour pressing on aqueduct if sylvius
  • haemorrhage
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8
Q

What is cerebral oedema?

A

Abnormal shifts of water between compartments of the brain.

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9
Q

What are the two types of cerebral oedema?

A
  • vasogenic

- cytotoxic

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10
Q

What is vasogenic oedema?

A
  • disruption of blood brain barrier.
  • usually around abscesses and tumours.
  • affects mainly the grey matter.
  • finger-like projections appearance on image.
  • can differentiate between white and grey matter.
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11
Q

What is cytotoxic oedema?

A
  • when extra cellular water moves into the cells causing them to swell.
  • affects mainly the white matter.
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12
Q

What is a cerebral infarct?

A

-an acute area of neurological deficit.

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13
Q

What are the causes of cerebral infarct?

A
  • cerebral haemorrhage.
  • cerebral thrombus.
  • cerebral embolus.
  • subarachnoid haemorrhage.
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14
Q

What is the predisposing factor of middle cerebral artery infarct?

A

-atherosclerosis

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15
Q

What produced the grey scale in CT?

A

-voxels.

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16
Q

Explain grey scale in CT

A
  • air is hypodense
  • CSF is hypodense
  • fresh blood is hyperdense
  • old blood is hypodense
  • bone is white/grey
  • metal is white/hyperdense
  • soft tissue is grey
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17
Q

What happens when an infarct ages?

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A

-gets more hypodense than the parenchyma it’s within.

18
Q

What are the appearances of an acute infarct?

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A
  • hyperdense area

- may have oedema surrounding it

19
Q

What is an epidural haematoma?

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A

-bleed between the dura mater and in table of the skull.

20
Q

What causes an epidural haematoma?

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A
  • head injury
  • skull fracture
  • laceration of meningeal vessels and dura sinus
21
Q

What are the appearances of an epidural haematoma?

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A
  • lens shapes
  • pushes on parenchyma of brain
  • does not cross sutures
  • can cross midline
22
Q

What is a subdural haematoma?

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A

-bleed between the dura and arachnoid mater.

23
Q

What causes a subdural haematoma?

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A
  • head injury

- laceration of the bridging vessels

24
Q

What are the appearances of a subdural haematoma?

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A

-noon/cresenteric shape

25
What do patients present with with a an epidural haematoma?
Period of relative lucency followed by declined consciousness
26
What type of contrast is air and when can it be used?
- negative contrast | - used in CT colonography
27
What is an oral contrast?
- iodine based preparations - given to patient 1 hour and 24 hours prior to examination to opacity the distal and proximal aspects of the gastrointestinal tract.
28
What is an IV contrast?
- usually iodine based contrast - can be given to vascular tree in phases - arterial= 20 seconds - venous= 70 seconds
29
What side affects do given contrast have?
- warmth feelings - metallic taste in mouth - feeling of urination
30
What is a contrast media?
- solution given to enhance tissues within the body. - has high molecular weight - high attenuation value of the organ it opacifies - can cause reactions
31
What is a glioma?
- most common primary tumour of the brain | - usually occupies the cerebral hemispheres and thalamus in adults and the posterior fossa in children.
32
What is a glioblastoma multiforme?
- high-grade glioma. - affects the temporal and frontal lobes of the brain. - causes seizures and raised intracranial pressure.
33
What is a cerebral haemorrhage?
-direct bleeding into the brain parenchyma
34
What causes a cerebral haemorrhage?
- hypertension | - head injury
35
What units is CT measured in?
-hounsfield units
36
What are the key midline structures?
- septum pellucidum - third ventricle - fall cerebri - pineal gland
37
What is a gyri and sulci?
- gyri is a fold of the brain surface | - sulci is a furrow between the gyri which contains CSF fluid
38
What are the three types of skull fractures?
- linear - depressed - basilar
39
What is a linear fracture?
- most common - break to bone but no displacement - involves entire thickness of the skull - tend to occur due to low-energy transfer from blunt trauma over a wide surface of the head - often no intervention is needed unless they involve vascular channel, venous sinus grove or a suture
40
What is a depressed fracture?
- clinically significant and require elevation - may be closed or open - require surgery - on plain film appear as prominent sclerotic margins along fracture site
41
What is a basilar fracture?
- most serious - linear break in the bone in base of skull - occur mostly in temporal/occipital condylar region - dural tear sign - fluid level in sphenoid sinus - raccoons eyes - CSF discharge from ears on nose - bruising behind ears

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