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Emergency Neuroradiology: Multimedia
Updated: Jul 23, 2009
Multimedia
 | Media file 1: Linear skull fracture - Emergency neuroradiology. Axial CT scan, bone window, shows linear skull fracture through the temporal squamosa (arrow). |
 | Media file 2: Epidural hematoma - Emergency neuroradiology. Axial CT scan, brain window, at the same level as Media file 1, shows left frontal epidural hematoma (arrow) displacing the falx and brain posteriorly and to the right. |
 | Media file 3: Linear skull fracture - Emergency neuroradiology. Axial CT scan through the posterior fossa shows a linear skull fracture of the occipital bone (arrow), near the sigmoid sinus. |
 | Media file 4: Subdural hematoma - Emergency neuroradiology. Axial CT scan at the same level as Media file 3, brain window, shows venous epidural hematoma (arrow). |
 | Media file 5: Subdural hematoma - Emergency neuroradiology. Axial CT scan though the level of the lateral ventricles shows right-sided subdural hematoma along the convexity (red arrow) and falx (green arrow), with severe midline shift from right to left. |
 | Media file 6: Subdural hematoma (noncontrast) - Emergency neuroradiology. Axial CT scan above the lateral ventricles shows extra-axial material (arrow) of approximately the same density as brain parenchyma, displacing the grey-white matter interface internally. Mild midline shift is seen. |
 | Media file 7: Subdural hematoma (contrast enhanced) - Emergency neuroradiology. Axial CT scan with intravenous contrast infusion, obtained at the same level as Media file 6, demonstrates the right isodense subdural hematoma (red arrow), enhancing veins (green arrow), and enhancement of the membrane (blue arrow). |
 | Media file 8: Subarachnoid hemorrhage - Emergency neuroradiology. Axial CT scan at the level of the mesencephalic cistern shows subarachnoid hemorrhage in the left sylvian fissure (green arrow) and the ambient cistern (red arrow). At least part of the density in the ambient cistern represents the aneurysm itself. |
 | Media file 9: Cerebral aneurysm - Emergency neuroradiology. Cerebral angiogram, anteroposterior projection, of a left vertebral artery injection demonstrates an aneurysm of the tip of the basilar artery (arrow). |
 | Media file 10: Skull fracture - Emergency neuroradiology. Lateral scout image from a CT brain examination shows linear lucency representing a right posterior frontal skull fracture (arrow). |
 | Media file 11: Subarachnoid hemorrhage - Emergency neuroradiology. Axial CT scan of the brain shows a right frontal cortical gyriform contusion, with a small amount of subarachnoid hemorrhage. Right scalp soft tissue swelling is also present (coup lesion). |
 | Media file 12: Diffuse axonal injury - Emergency neuroradiology. Axial CT scan, brain window, shows diffuse low density and loss of grey-white matter differentiation throughout the cerebral hemispheres (arrows), consistent with diffuse edema and swelling. |
 | Media file 13: Diffuse axonal hemorrhage - Emergency neuroradiology. Axial CT scan, 24-hour follow-up postictus, demonstrates progression of swelling and diffuse edema. |
 | Media file 14: Parenchymal hemorrhage - Emergency neuroradiology. Axial CT scan shows sharply defined oval hyperdensity in the right lentiform nucleus (arrow) representing an acute hypertensive-type hemorrhage. Minimal edema is present in this acute setting. |
 | Media file 15: Parenchymal hemorrhage - Emergency neuroradiology. Axial CT scan shows irregularly shaped right frontoparietal acute parenchymal hemorrhage (arrow). |
 | Media file 16: Arteriovenous malformation - Emergency neuroradiology. Cerebral angiogram, lateral projection, of a right internal carotid artery injection demonstrates a right frontoparietal arteriovenous malformation (AVM), with prominent early draining veins (arrow) extending cephalad to the superior sagittal sinus from the AVM nidus. (The patient is facing to the left.) |
 | Media file 17: MCA stroke - Emergency neuroradiology. Axial CT scan shows a peripheral wedge-shaped area of decreased density (arrow) involving the right caudate head and lentiform nuclei, insula, and frontal and temporal lobes, consistent with a subacute right proximal middle cerebral artery occlusion and subsequent cerebrovascular infarction. A mild mass effect and shift of the midline to the left is shown. |
 | Media file 18: MCA stroke - Emergency neuroradiology. Axial CT scan at the level of the basal cisterns shows the "hyperdense middle cerebral artery (MCA) sign" (arrow) representing acute clot within the right middle cerebral artery, accounting for the patient's clinical symptoms. |
 | Media file 19: Skull fracture - Emergency neuroradiology. Lateral scout image from a CT brain examination shows linear lucency representing a left parietal skull fracture. |
 | Media file 20: Child abuse - Emergency neuroradiology. Axial CT scan of the brain shows multiple hemorrhages of multiple ages, pathognomonic for child abuse. Hyperdense hemorrhage is seen in several left-sided chronic subdural loculations (red arrow). Right extra-axial fluid collection exerts mass effect (green arrow) and indicates prior, chronic subdural hematoma/hygroma, with acute hemorrhage dependently (blue arrow shows desaete layering). Also, a small amount of interventricular blood is present in the atrium of the right lateral ventricle. |
 | Media file 21: Skull fracture - Emergency neuroradiology. Axial CT scan of the brain with bone windowing at a higher level shows the left parietal skull fracture (arrow) seen on the "scout" image. Absence of bone anteriorly is the anterior fontanel, with visualization of the posterior portion of the sagittal suture noted in the midline posteriorly. |
 | Media file 22: Penetrating trauma - Emergency neuroradiology. Lateral scout image from a CT scan of the brain shows a metal bullet overlying the expected location of the suprasellar cistern. |
 | Media file 23: Penetrating trauma - Emergency neuroradiology. Axial CT scan of the brain at the level of the suprasellar cistern shows severe streak artifact from the hyperdense metal bullet (arrow). The bullet entered from a right temporal location (right temporalis muscle swelling) and traveled to the midline (linear horizontal hyperdensity). |
 | Media file 24: Penetrating trauma - Emergency neuroradiology. Lateral scout image from a CT scan of the brain shows linear metal ice pick (arrow at ice pick point in the suprasellar cistern) overlying the anterior cranial fossa. |
 | Media file 25: Penetrating trauma - Emergency neuroradiology. Axial CT scan of the brain at the level of the suprasellar cistern shows the path of the distal portion of the ice pick (arrow), extending the suprasellar cistern in the midline. This is the expected location for the internal carotid artery bifurcation. |
 | Media file 26: Angiography - Emergency neuroradiology. Anteroposterior projection of a right common carotid artery angiogram shows the close proximity of the ice pick (arrow) and the internal carotid artery bifurcation into the anterior and middle cerebral arteries. |
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Further Reading
Keywords
emergency neuroradiology, neuroimaging, neuroimaging in ED, emergency department, head trauma, cranial trauma, head injury, cranial injury, cranial imaging, computed tomography, head CT, magnetic resonance imaging, head MRI, angiography
