CT in Brain Emergency

Mohamed SamirLecturer – Radiology DepartmentFaculty of Medicine - Alexandria

Our aim:

• Basics of CT Brain

• Normal Anatomy

• Emergencies:

Trauma

Stroke

Basics of CT Brain

Basics of CT Brain Gross Anatomy

• Adult brain is formed of:

1. Cerebral hemispheres.

2. Brain stem.

3. Cerebellum.

All are covered with meninges, floating in a

fluid (CSF) & enclosing a cavity

(ventricular system).

Ventricular system

Basics of CT Brain Gross Anatomy

Components: ● 2 lateral ventricles → inside cerebral

hemispheres. ● third ventricle. ● aqueduct of Sylvius → inside brain stem. ● fourth ventricle → inside pons &

medulla oblongata.

Foramina:

Choroid plexus: a network of blood vessels that produce

CSF.

Basics of CT Brain Gross Anatomy

Cerebral hemisphere:

Gray matter:

Cortex

Ganglia/nuclei

White matter

Basics of CT Brain Gross Anatomy

BASAL GANGLIA

♣ Islands of neural cell bodies (grey matter) within the

white matter.

♣ Formed of:

1- Caudate nucleus (head, body & tail).

2- Putamen.

3- Globus pallidus.

4- Amygdaloid nuclear complex (amygdala).

5- Claustrum.

Globus pallidus + Putamen = Lentiform nucleus.

How to Perform Brain

CT

How to Perform Brain CT

How to Perform Brain CT

How to Perform Brain CT

How to Perform Brain CT

Brain Emergencies

Brain Emergencies

Stroke

Ischemic Hemorrhagic

Trauma

Bone Parenchyma(Intra-axial)

Extra-axial

Extradural Subdural Subarachnoid

Stroke

Hemorrhagic Ischemic

Blood Edema White Dark

Hemorrhagic Stroke

Hemorrhagic Stroke

Blood

Hemorrhagic Stroke

Hemorrhagic Stroke

Hemorrhagic Stroke

Hemorrhagic Stroke

Ischemic Stroke

Ischemic Stroke

Hyperdense MCA sign

Ischemic Stroke

Lost G-W matter differentiation

Ischemic Stroke

Lost G-W matter differentiation

Ischemic Stroke

Ischemic Stroke

Ischemic Stroke

Ischemic Stroke

Trauma

Skull Fracture/Fissure

Trauma

Skull Fracture/Fissure

Trauma

Trauma

Intra-axial Hematoma

Trauma

Extra-axial Hemorrhage:

1. Extradural

2. Subdural

3. Subarachnoid

Trauma Meninges

Trauma

Extradural Hemorrhage

Trauma

Extradural Hemorrhage

Trauma

Extradural Hemorrhage

Trauma

Extradural Hemorrhage

• Convex

• Might be associated with a fissure

• Dos not cross sutures

• Less mass effect

Trauma

Extradural Hemorrhage

Trauma

Extradural Hemorrhage

Trauma

Subdural Hemorrhage

Trauma

Subdural Hemorrhage

• Concave

• Can cross sutures

• Not associated with fissure

• More mass effect

Trauma

Subdural Hemorrhage

Trauma

Subdural Hemorrhage

Trauma

Subdural Hemorrhage

Trauma

Subdural Hemorrhage

Trauma

Trauma

????

Blood

Hyperacute Acute Subacute Chronic

Dark/Mixed White Dark Gray

Trauma

Subarachnoid Hemorrhage

Trauma

Trauma Subarachnoid Hemorrhage

Trauma Subarachnoid Hemorrhage

Trauma Subarachnoid Hemorrhage

Spontaneous Subarachnoid Hemorrhage

Vascu la r

Ma l fo rmat ion

(Aneurysm)

Thank You