What is CT Scanning of the Head?

CT scanning (CAT scanning) is a

noninvasive
medical test
CT scanning combines special x-ray
equipment
with sophisticated computers to produce
multiple images or pictures of the inside
of the
body
CT scanning provides more detailed
information on head injuries, stroke,
brain
tumors and other brain diseases than
regular
What are some common uses of
the procedure?

CT scanning of the head is typically used to

detect:
Bleeding, brain injury and skull fractures in
patients
with head injuries.
Bleeding caused by a ruptured or leaking
aneurysm in
a patient with a sudden severe headache.
A blood clot or bleeding within the brain
shortly after
a patient exhibits symptoms of a stroke.
A stroke, especially with a new technique
called
Perfusion CT.
Brain tumors.
Enlarged brain cavities (ventricles) in
patients with
CT scanning is also performed to:
Evaluate the extent of bone and soft tissue damage in
patients
with facial trauma, and planning surgical
reconstruction.
Diagnose diseases of the temporal bone on the side of
the skull,
which may be causing hearing problems.
Determine whether inflammation or other changes are
present in
the paranasal sinuses.
Plan radiation therapy for cancer of the brain or other
tissues.
Guide the passage of a needle used to obtain a tissue
sample
(biopsy) from the brain.
Assess aneurysms or AVM through a technique called
CT
angiography.
 Indication for CT Scan :

Decrease of
consciousness(GCS<1
5).
Skull fracture
Clinical sign of skull
base fracture
Persistent
headache/vomit
Penetrating injury
Seizure
Neurologic defisit
(lateralization)
Diastasis Fracture
Linear Fracture
Linear Fracture
Depressed Fracture
Depressed Fracture
3D Reconstruction image showing a
large fracture of the skull.
A. Orbit
B. Sphenoid Sinus
C. Temporal Lobe
D. External Auditory Canal
E. Mastoid Air Cells
F. Cerebellar Hemisphere
A. Frontal Lobe
B. Frontal Bone
C. Dorsum Sellae
D. Basilar Artery
E. Temporal Lobe
F. Mastoid Air Cells
G. Cerebellar Hemisphere
A. Frontal Lobe
B. Sylvian Fissure
C. Temporal Lobe
D. Suprasellar Cistern
E. Midbrain
F. Fourth Ventricle
G. Cerebellar Hemisphere
A. Falx Cerebri
B. Frontal Lobe
C. Anterior Horn of Lateral Ventricle
D. Third Ventricle
E. Quadrigeminal Plate Cistern
F. Cerebellum
A. Anterior Horn of the Lateral Ventricle
B. Caudate Nucleus
C. Anterior Limb of the Internal Capsule
D. Putamen and Globus Pallidus
E. Posterior Limb of the Internal Capsule
F. Third Ventricle
G. Quadrigeminal Plate Cistern
H. Cerebellar Vermis
I. Occipital Lobe
A. Genu of the Corpus Callosum
B. Anterior Horn of the Lateral Ventricle
C. Internal Capsule
D. Thalamus
E. Pineal Gland
F. Choroid Plexus
G. Straight Sinus
A. Falx Cerebri
B. Frontal Lobe
C. Body of the Lateral Ventricle
D. Splenium of the Corpus Callosum
E. Parietal Lobe
F. Occipital Lobe
G. Superior Sagittal Sinus
A. Falx Cerebri
B. Sulcus
C. Gyrus
D. Superior Sagittal Sinus
Linear skull fracture of the right parietal bone
(arrows).
Depressed Fracture
Pneumocephalus
 Epidural
Hematoma
Epidural Hematoma
Biconvex (lenticellular) epidural hematoma
(arrowheads),
deep to the parietal skull fracture (arrow).
subdural hematoma (SDH) in an
injured patient
High density, crescent shaped hematoma (arrowheads)
overlying the right cerebral hemisphere. Note the shift
of the
normally midline septum pellucidum due to the mass
effect arrow.
The hypodense region (arrow) within the high
density
hematoma (arrowheads) may indicate active
bleeding.
Subdural Hematoma
Subacute subdural hematoma (arrowheads). Note the
compression of
gray and white matter in the left hemisphere due to the
mass effect.
 This chronic subdural hematoma (arrowheads)
shows
the septations and loculations that often occur over
time.
Crescent shaped chronic subdural hematoma
(arrowheads). Notice
the low attenuation due to reabsorbtion of the
hemorrhage over time.
 Multiple foci of high density corresponding to
hemorrhage (arrows) in an area of low density
(arrowheads) in the left frontal lobe due to cerebral contusion.
Cerebral Contusion
Intraserebral
Hematoma
 Intraparenchymal or intracerebral hemorrhage (arrow), a subarachnoid
hemorrhage (arrowhead), or blood surrounding the surface of the brain; and
edema (asterisk), or swelling of the brain.
Intraventricular
Hematoma
Intraventricular hemorrhage (arrow) found in
a trauma
patient. Note the subarachnoid hemorrhage
in the
sulci in the subarachnoid space (arrowheads).
High density blood (arrowheads) fills the sulci over
the
right cerebral convexity in this subarachnoid
hemorrhage.
 HEAD INJURY
Indication for hospitalized :
Decrease of consciousness
Headache (moderat to severe)
History of unconscious > 15 mnt
Skull Fracture
Rhinorea otorhea
Penetration injury
Alkohol/drugs intoxication
Significant multiple trauma
Abnormal CT Scan
Amnesia
No family at home
 Kapan pasien dipulangkan?

Tidak memenuhi kriteria rawat

Berikan informasi kemungkinan
kembali ke RS segera bila keadaan
memburuk
Berikan jadwal ke Poliklinik ( 1
minggu )

Pulang dengan nasihat dan

 Nasihat pulang
Segera kembali ke rumah sakit
secepatnya bila:
Penurunan kesadaran (sulit
dibangunkan)
Kejang
Pupil mata menjadi tidak sama
ukurannya
Lumpuh sebelah
Nyeri kepala makin bertambah walau
sudah minum obat