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
radiographs (x-rays)
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
hydrocephalus.
• Diseases or malformations of the skull.
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<15).
 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
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