Arcangelo Panzica Head Trauma Ct

Università
di
Torino Facoltà
di
Medicina
e
Chirurgia Corso
di
Laurea
Magistrale
in
Scienze
delle
Professioni

Sanitarie
Tecniche
DiagnosAche

Inglese
I

­
Prof.ssa
M.J.Teriaca

COMPUTED
TOMOGRAPHY
IN
HEAD
TRAUMA

A.A. 2009

Arcangelo Panzica

Epidemiology • In Italy 130.000 people treated every year; • 7000 Italians die as a result of T. B. injury each year; • 45% transportation accidents, 26% falls, 17% assaults; • € 500 milions annually; • € 5000 for 36-hours stay at hospital.

WorkUp 

CT without contrast (most sensitive study) 

best within 24 hrs after event; at day 3 is 80% sensitive, 50% at 1 week



may be negative in 10-15% of patients

CT Scan on TBI Detection of : • Skull fractures, scalp hematoma; • Extracerebral lesions

(Subarachnoid Hemorrhage, Subdural Hematoma, Epidural Hematoma)

• Intracerebral lesions

(Diffuse Axonal Contusion, Intraventricular Hemorrhage)

Injury,

Cerebral

Technique

Normal Anatomy A. Falx Cerebri B. Frontal Lobe C. Anterior Horn of Lateral Ventricle D. Third Ventricle E. Quadrigeminal Plate Cistern F. Cerebellum

TBI

meningeal artery

bridging veins

Acute Subdural Haematoma

• • • • • •

High Density Irregular inner margin Does not cross dural reflections Can be bilateral Shift of midline septum Active bleeding (hypodense)

Acute Epidural Haematoma

• • • • • •

Biconvex (lenticular) shape High Density Can cross the dural reflections Usually associated with fracture Shift of midline septum Air bubble

Subarachnoid haemorrhage

Intracerebral Haemorrhage Haemorrhagic contusion

IVH

Post Processing