Neurotrauma Radiology

What is this?

Extradural haematoma Any patients Usually high impact Usually associated fracture Arterial bleed – peels dura off skull under pressure Usually clinical deterioration <4 hours post injury

What else? Thickness – in mm at widest point Midline shift – in MM at most shifted point Effacement of ventricles

What is this?

Subdural haematoma Older people Often minor injury/shearing force (25% no trauma Hx) Brain shrinks with age, subdural veins under some tension Slow bleed – often present weeks-months later Dcreased LOC, headache, ataxia, cognitive dysfunction, Motor deficit, aphasia

What else? Thickness/Midline shift/ventricles Age: Acute 21 days

What is this?

Subarachnoid haemorrhage Can be traumatic, aneurysmal, hypertensive Sudden onset severe headache +/- neurology 80% from ruptured aneurysm CTB is 100% sensitive in first 6 hours*

Can look like this

Or this

Don’t rule out an SAH by looking at the CT yourself

Help me Dr! my basal cisterns are effaced!