CT heads

Question 1

CT head of intracranial haemorrhage

Answer 1

Hypodense mass in confined area, surrounded by low density oedema ring. Can cause compression of ventricles (ventricular effacement).

Question 2

CT head of subarachnoid haemorrhage and other Ix

Answer 2

High attenuation from blood in sulci (spider/star), herniation or hydrocephalus.
Common causes = trauma and ruptured berry aneurysm.
If CT negative but high suspicion LUMBAR PUNCTURE!

Question 3

CT head of subdural haematoma and management

Answer 3

banana/sickle/crescent shape hyperdensity.
Midline shift
Compressed sulci.
Mx = cranial burr hole and haematoma evacuation.

Common in elderly and alcoholics.
Tear in bridging veins.

Question 4

CT head of extradural hemorrhage

Answer 4

Lemon/bi-convex shape hyperdensity outside of cerebral hemisphere. Compression and displacement of underlying paraenchyma.
Tear in middle meningeal artery from trauma. Lucid interval then neuro deterioration.

Question 5

CT head of infarction/ischaemic stroke

Answer 5

Early changes = loss of grey and white matter differentiation. oedema, low attenuation in area of affected artery (e.g. MCA).
Over time area becomes very low density.