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 Injury, Cerebral

Contusion, Intraventricular Hemorrhage)
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