CT Head Trauma ; Lecture

Question 1

Why is head trauma significant in clinical practice?

Answer 1

It is the leading cause of death in people under 30. Males are 2-3 times more likely to sustain brain injuries, primarily due to motor vehicle accidents, assaults, and falls in the elderly.

Question 2

The two most common causes of head trauma are _________ and _________.

Answer 2

motor vehicle accidents; assaults.

Question 3

What are the key indications for a CT head in trauma?

Answer 3

To assess for fractures of the cervical spine or skull.
To evaluate brain asymmetry, subarachnoid hemorrhage, and fractures.
To differentiate intra-axial (brain) from extra-axial (outside brain) masses.

Question 4

CT head scans rely on the principle of _________ and _________ windows to evaluate bones and soft tissues.

Answer 4

bone; brain.

Question 5

What structure runs across the top of the brain?

Answer 5

Falx cerebri.

Question 6

True/False: The lateral ventricles contain cerebrospinal fluid (CSF).

Answer 6

true

Question 7

The _________ lobe is located at the back of the brain and is responsible for visual processing.

Answer 7

occipital

Question 8

What are the four main spaces where blood can accumulate in traumatic brain injury (TBI)?

Answer 8

Extradural/epidural (between skull and dura).
Subdural (between dura and arachnoid membrane).
Subarachnoid (in the CSF space).
Intra-axial (within the brain tissue).

Question 9

True/False: Acute blood appears hyperdense (bright) on a CT scan.

Answer 9

true

Question 10

Over time, acute blood on a CT scan transitions from _________ to _________ to _________.

Answer 10

hyperdense; isodense; hypodense.

Question 11

What is the characteristic shape of an EDH on a CT scan?

Answer 11

Lentiform/convex shape.

Question 12

EDH is most commonly caused by laceration of the _________ or dural veins.

Answer 12

middle meningeal artery.

Question 13

What is the management threshold for an EDH?

Answer 13

EDH >30 cm³ should be evacuated surgically.

Question 14

How does SDH differ from EDH in its CT appearance?

Answer 14

SDH appears concave and can cross sutures but not dural reflections (e.g., falx or tentorium).

Question 15

The most common cause of SDH is disruption of _________ veins.

Answer 15

bridging cortical.

Question 16

True/False: Acute SDH with >10 mm thickness or >5 mm midline shift requires surgical evacuation.

Answer 16

True.

Question 17

Where should you look for SAH on a CT scan?

Answer 17

In the interpeduncular cistern and Sylvian fissure.

Question 18

A diffuse SAH is typically caused by a _________ rupture.

Answer 18

aneurysm.

Question 19

What is the most common cause of IVH?

Answer 19

Rupture of subependymal vessels or reflux of SAH.

Question 20

True/False: IVH can result in a blood-CSF level seen in the occipital horns of the ventricles.

Answer 20

True

Question 21

What is a significant feature of a “depressed” skull fracture?

Answer 21

The inner table is depressed by the thickness of the skull and may overlie major venous sinuses or arteries.

Question 22

Longitudinal temporal bone fractures are associated with _________ hearing loss, while transverse fractures are linked to _________ hearing loss.

Answer 22

conductive; sensorineural.

Question 23

What are three critical aspects to assess on a CT head in trauma?

Answer 23

Associated fractures.
Types of bleed.
Complications such as midline shift or cerebral edema.

Question 24

Early and accurate diagnosis of head trauma on a CT improves _________ and _________.

Answer 24

mortality; morbidity.