Transcript Lecture 8-Radiology of Common Brain Diseases.ppt

Radiology of common
brain diseases
366 RAD
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Scope
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Intracranial bleeding
Brain ischemia
Brain edema
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Intracranial tumors
Brain infections
Brain inflammation
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Intracranial Bleeding
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Extradural
Subdural
Subarachnoid
Intraventricular
Intraparenchymal
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EDH
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Blood collection between inner
table and dura.
Biconvex (lentiform)
Occur at site of impact
95% unilateral, supratentorial
Does not cross sutures
Can cross falx and tentorium
Skull fracture in 90%
Air seen in 20%
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EDH
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Arterial 90%, Venous 10%
Nontraumatic-rare
Lucid interval-50%
C/F: headache, nausia, vomiting, convulsions,
herniation.
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SDH
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Blood collection between dura
and arachnoid.
Crescent shape
Supratentorial
Cross sutures, but not dural
attachments
May extend along falx and
tentorium
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SDH
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Trauma is the most
common cause
Acute: 6hr-3d
Subacute: 3d-3w
Chronic: >3w
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SDH
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SDH
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Blood in the suprasellar cistern
Blood in the interhemispheric fissure
Blood in the ambient cistern
Blood in the sylvian fissures
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SAH
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Blood between pia and arachnoid
Traumatic (most common)
Nontraumatic
C/F: headache, vomiting, blurred vision, neck
rigidity
Complications: hydrocephalus (acute/delayed),
vasospasm, rebleeding.
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Parenchymal bleed
Causes:
HTN, trauma, AVM, aneurysm, permaturity,
tumors, infarction, coagulopaty.
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Trauma
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Trauma
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Courtesy: Osborn AG
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Courtesy: Smithuis R
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T2WI
FLAIR
DWI
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FLAIR
DWI
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Brain edema
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Vasogenic:
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Trauma/infection/inflammation/tumors
Cytotoxic:
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Ischemia/trauma
• Both could be generalized or localized
• Both may co-exist
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Brain edema
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Imaging findings:
Hypodensity on CT
 Low signal on T1, high signal on T2 & FLAIR
 Loss of GM/WM interface
 Compressed ventricles
 Effaced sulci & Cisterns
 Dense cerebellum
 Brain herniation
 Vascular compression-ischemia
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Brain edema
3w later
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Brain edema
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Brain edema
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Brain edema
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Brain edema
Vasogenic
Cytotoxic
White matter
Gray matter
DWI
Non-restricted
Restricted
Shape
Finger-like
Diffuse
Location
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The cause of this hematoma is:
A.
B.
C.
D.
Courtesy of Chong V.
Anticoagulation
Hypertension
Ruptured aneurysm
Trauma
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??
Normal
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SDH
IVH
SAH
Pneumocephalus
Edema
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This CT shows:
A.
B.
C.
D.
Subdural hematoma
Subarachnoid hemorrhage
MCA infarction
All of the above
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This CT shows:
A.
B.
C.
D.
Epidural hematoma
Subdural hematoma
MCA infarction
Normal brain
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Compressed
lateral ventricle
Obliterated
CSF space
Normal sulci
Subdural
hematoma
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Intracranial bleeding
Brain infarctions
Brain edema
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