1. Erin O’Connor NEURORADIOLOGY TRAUMA WORKSHOP

2. LEARNING OBJECTIVES Know the appropriate imaging work up for patients with head trauma. Recognize the appearance of intracranial hemorrhage on CT, specifically epidural, subdural, subarachnoid and intraparenchymal hemorrhage. Describe the various types and causes of brain herniation. Recognize the typical changes in appearance of intracranial blood products with age on CT See the typical appearance of diffuse axonal injury on MRI and CT List criteria that are used in spinal trauma to determine if the patient should have CT of the cervical spine. Describe some of the traumatic injuries than can be seen on a lateral c-spine radiograph

3. TRAUMA TO THE HEAD What imaging modality would you use? What are you looking for? Why not use MRI is setting acute trauma to head?

17. BRAIN CONTUSIONS What are they? Where do they typically occur?

20. Figure 9. Acute trauma in a 17-year-old pregnant girl after a rollover motor vehicle accident in which she lost consciousness. Goldman S M, Wagner L K Radiographics 1999;19:1349- 1357 ©1999 by Radiological Society of North America

26. DIFFUSE AXONAL INJURY What is it? How do patients get it? Describe the clinical picture of DAI? Where does it occur? What is the best way to detect it on imaging?

32. TRAUMA TO THE NECK What imaging modality would you use? What are you looking for?

33. NORMAL CT CERVICAL SPINE

36. Medrol 32 mg po (or its equivalent) 12 and 2 hours prior to contrast administration. Some also give benadryl at time of contrast adminstration Cardiac pacemakers, insulin pumps, neurostimulators, cochlear implants Non-graphite spinal cord tongs: Graphite tongs are compatible. Thermodilution Swan-Ganz catheter: Local heating can result. Metal outside the brain and eye is NOT a contraindication: Cardiac valves, inferior vena cava filters, biliary and vascular stents, IUD's and metallic prostheses are safe, unless doubt as to positional stability. Plain radiography sufficient for screening. BUT WHAT IF… CONTRAINDICATIONS TO MRI KNOWN ALLERGIES TO CONTRAST