Imaging of brain and skull traumas

Question 1

Aneurysms definition

Answer 1

50% wider than normal vessel diameter

Question 2

Berry aneurysms and Charcot-Bouchard aneurysms

Answer 2

Occur along the circle of willis: In order of most common sites
ACA
ICA
MCA

Charcot-Bouchard aneurysms of smaller vessels, especially the lenticulostriate arteries.

Question 3

Cerbral venous sinus thrombus
What causes them

How do they appear on imaging

Answer 3

Often occur secondary to local infection.
Dehydration
Skull or spinal trauma

Hypercoagulability states

Is diagnosed by Contrast CT scan.
They are hyperdense, thrombi are hyperdense

Loss of enhancement (flow) in the thrombosed segment.

After some time, there will slowly developing infarct edema in the congested regions.

Question 4

Dural venous thrombosus

symptoms and treatment

Answer 4

symptoms: usually just headache, progressing to stroke symptoms, neurological deficits, paresthesias or paralysis of limbs, seizures in up to 40%.
Possible elevated ICP, which can be relieved by lumbar puncture.

Hemorrhages may occur adjacent to the obstructed sinus, which contraindicates anticoagulation until bleeding has stopped.

Treatment is conservative with Heparin and anticoagulants in most cases unless the symptoms are severe, then thrombolysis is indicated.