2. IN THE NAME OF ALLAH THE MOST MERCIFUL, THE MOST KIND “Blessed is He in Whose hand is the Sovereignty, and He is Able to do all things Who hath created life and death that He may try you, which of you is best in conduct; and He is the Mighty, Forgiving,” ………………(67:1-2)

3. IMAGING of Head / Brain Dr. Rashed Nazir

4. IMAGING of Head / Brain What to image How to image / imaging modalities

5. RADIOGRAPHY

6. INDICATIONS The presence of a palpable vault abnormality which feels bony. As part of an imaging protocol for specific clinical problems after discussion with radiologists e.g. skeletal survey for myeloma. Facial views are of use following trauma to facial skeleton or mandible. Facial views may be of use following trauma to the orbit, or possibility of metallic foreign body

7. Linear fracture

8. Depress fracture

9. Fracture

10. Multiple myeloma

12. CT SCAN

15. MRI

16. Normal

18. INDICATIONS Trauma: haemorrhages, brain contusions and skull fractures. Stroke Brain tumors. Hydrocephalus Infections (encephalitis, abscesses)

19. White matter diseases (Demyelinating / dysmyelinating e.g. MS, leukodystrophy) Diseases of the temporal bone. Determine whether inflammation or other changes are present in the paranasal sinuses. Plan radiation therapy for cancer of the brain or other tissues. Guide biopsies. Assess aneurysms or AVM

20. Fracture frontal bone

26. Extradural Haematoma Occurs when vessel (middle meningeal artery) in the extradural space is torn by trauma.

27. Extra dural hematoma

29. Subdural Haematoma Also due to traumatic bleed into potential space between the dura and arachnoid mater, when a bridging vein is torn. Can extend into the interhemispheric fissure and the root of the sylvian fissure but not into other sulci.

30. Sub dural hematoa

35. Subarachnoid Haemorrhage Occurs into the subarachnoid space from spontaneous or traumatic rupture of, usually an artery, in this space. Blood can then be seen in the cisterns and extending into the sulci and fissures on the brain surface close to the site of bleeding.

36. Subarachnoid hemorrhage

38. Brain abscess

39. Abscess

41. ADEM

42. MS

45. Leukodystrophy

46. Tumour

49. Metastasis

50. Meningioma

51. Hydrocephalus

52. Stroke

54. PICA

55. ACA

56. MCA

57. PCA

58. ROLE OF MRI

61. Basal ganglia hematoma

63. Late Subacute bleed on MRI

64. ANGIOGRAPHY

66. MRA

67. CTA Head

68. CTA

69. Dense MCA sign

71. DST

72. Venography

73. Superior sagittal sinus thrombus

74. MR Venography

75. SPECT

76. PET

77. CEREBRAL PERFUSION SPECT Diagnosis and conformation of Alzheimer's disease and other forms of dementia. Localization of electrical and nonelectrical seizure foci. Evaluation of location, size, and prognosis of cerebral ischemia and stroke patients. Evaluation of AIDS dementia. Changing brain perfusion during various types of interventions.

78. Evaluation of brain injury. Evaluation of patients with psychiatric and mood disorders. Detection and localization of recurrent brain tumor (Tc-99m and Tl-201agents). Localization of Speech center Diagnosis of brain death.

79. CISTERNOGRAPHY Diagnosis of normal pressure hydrocephalus. Identification of cerebrospinal fluid (CSF) leaks.