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RADIOLOGY Surgery Decury

Dr. Ray Anthony Leung

CASE 1
History:
 Female patient is a passenger, wasn’t wearing
seatbelt, driving cruising in SCTEX, hit a vehicle, had
an head-on collision.
 So you could see small whites here, surrounded by
black areas.
 White= blood.
 Another case of CONTUSION ON BOTH FRONTAL
LOBES.
 Contusion should be dark/black but since there is
blood may puti.

BONE WINDOW, COMPLETE DESTRUCTION OF FRONTAL


BONE.
Case of massive compound comminuted fracture of frontal
bone involving frontal lobe. There are contusion and
hemorrhage. So this is a classic case of MAXILLOFACIAL AND
HEAD TRAUMA.

SINUSES FILLED WITH BLOOD


CASE 2
By careful inspection of the bones, you can see a lucent line.
That is a fracture. Epidural hematoma goes hand in hand with
fractures. DON’T FORGET.

CASE 3
History
 Bullet fragements.
 Metals are hyperdense. It emits artifacts.
 This is a classic MULTIPLE METALLIC FRAGMENTS
INSIDE THE BRAIN.
 This patient was shot close range and nagdisperse
ung bala. Kumalat (It spread out).
 So this is a classic case of gunshot injury with multiple
fractures.

SURGERY 2: RADIOLOGY 

What do you think is this? This hyperdense structure?

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--INTRAAXIAL BLOOD. Contusional hemorrhage or
hematoma. Bleeding inside the brain because of the trauma
brought about by the gunshot injury.

CASE 4
 SUBACUTE SUBDURAL HEMATOMA: Crescent/C-shaped
blood. Why subacute? Acute, blood is very dense.
 Isodense, density is the same as the brain parenchyma.
 SUBDURAL: big, crescent

 There is Extra
axial blood.
 So this is a case
of SUBACUTE
SUBDURAL
HEMATOMA.
Very good
example to show
the sulci.

CASE 5
History:
 The patient is found lying unconscious in a room with
questionable trauma.

SURGERY 2: RADIOLOGY 

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BLOOD (WHITE) INSIDE THE SULCUS BLOOD AROUND THE MIDBRAIN and PONS

This is a case of SUBARACHNOID HEMORRHAGE caused by


trauma. It is mostly caused by a ruptured aneurysm.
- Extraaxial blood.

SYLVIAN FISSURE WITH BLOOD.


SURGERY 2: RADIOLOGY 

Red: Sylvian fissure; yellow: sulcus; green: pons and


midbrain

CRANIUM
EXTRAAXIAL SPACE - in between the bone and the brain
a. Epidural
b. Subdural
c. Subarachnoid space

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INTRAAXIAL STRUCTURE - Brain
CASE 7
SUBARACHNOID HEMORRHAGE
- Most common cause of non traumatic subarachnoid SUBDURAL HEMORRHAGE
hemorrhage is ruptured aneurysm.
- Cresent-shaped blood
- Acute
CASE 6

CONTUSION HEMORRHAGE OR HEMATOMA


- Intraaxial
- Big blood collection in the temporal area
- Dilemma: patient is hypertensive
- Blood – is it secondary to stroke or trauma
o Stroke – blood occurs most commonly in the
basal ganglia
- Thus this is secondary to trauma
- With compression of the ventricles
- Brain pushed to the left

SURGERY 2: RADIOLOGY 

INTERHEMISPHERIC SUBDURAL HEMATOMA

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EPIDURAL HEMATOMA
- Convex shaped blood

BUKOL SA SCALP; EXTRAAXIAL EPIDURAL HEMATOMA WITH


GRGGRRREGSCALP HEMATOMA

SUBARACHNOID HEMORRHAGE AT THE RIGHT SIDE


TENTORIUM
- Tentorium: Tent like structure that divides the upper
hemisphere, cerebral from cerebellar hemisphere.; s
was coated with blood – right side

SURGERY 2: RADIOLOGY 

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FRACTURE OF THE BONE

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Notetakers: Guia Marie Canonizado | Judy Mae Lawagan
Proofreader: Lianne Camille Sinagub
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SURGERY 2: RADIOLOGY 

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