文档介绍：HEAD TRAUMA
Radiology, The Second Affiliated Hospital ,
Shantou University , Medical College
郑文斌
CNS trauma Cldetection in the subacute stage, and at estimating age of subdural hematoma
Can allow differentiation of epidural/subdural because of direct visualization of the dura , especially on coronal imaging
Subarachnoid hemorrhage
Subarachnoid hemorrhage
The sensitivity of CT has been reported to range from 85 to 100 %.
high density lesion was demonstrated in cerebral cisterns（Subarachnoid space over cerebral convexity, Suprasella cistem, interpeduncular cistern, pontine cistern, cistern of the lateral fissure） by plain CT scan Computed tomography (CT) is the method of choice to detect acute subarachnoid hemorrhage (SAH).
Subarachnoid hemorrhage-MRI
Magnetic resonance imaging (MRI) using FLAIR sequences shows a comparable sensitivity in acute SAH even be superior to CT. (hyperintense on T2 FLAIR )
In subacute SAH, starting from day 5 after the suspected hemorrhage, the sensitivity of MRI is clearly superior to CT. (hyperintense on T1WI and T2WI)
CEREBRAL CORTICAL CONTUSION
Scoure of blood
Traumatic/Mechanical Disruption of small (capillary) Vessels
Admixture of blood mixed with Native Tissue(Petechial hemorrage)
Mottle/Speckled Density
(“Salt and pepper” on CT)
CEREBRAL CORTICAL CONTUSION
Presentation
Loss of consciousness, headache, mental status change
Usually in a superficial cortical location
50% occur in temporal lobe
33% in frontal lobe (frontal pole and inferior surface)
Delayed hemorrhage seen in 20%
CEREBRAL CORTICAL CONTUSION-CT
Ill-defined mixed hypodense and hyperdense lesions -hemorrhage and edema
May coalesce 1-2 days after trauma
Edema and mass effect related to contusion
CEREBRAL CORTICAL CONTUSION-MRI
More sensitive than CT in identifying nonhemorrhagic lesions
Multiple areas superficial T2 hyperintensity indicating edema
Heterogeneous T1/T2 signal intensity dependent