Download MBBS Radio-diagnosis and Imaging Presentations 1.Imaging Of Traumatic Brain Injury Lecture Notes

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Learning Objectives

? To learn mechanisms of various TBI
? To identify common TBI
? To identify complications of TBI

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Epidemiology

? 10 million people suffer from TBI every year globally
? 10% are fatal
? 5-10% sustain chronic disabilities

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? 20-25% have moderate disabilities

Modes of injury

? Missile / Penetrating injury

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? Non missile injury ? road traffic accidents, falls.

? Ground level falls in children and elderly adults
Classification

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Primary injury

Secondary injury

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? occurs at the time of injury

? Due to mass effect

? Fractures

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? Herniations

? Intracranial hematoma

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? Edema

? Contusions

? Ischemia

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? Lacerations

? Vascular injuries

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? DAI

Modalities

? Radiographs / X-rays

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? NCCT

Can only identify fractures

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Preferred screening tool

Intracranial injuries can not be

Bone injuries

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detected

Parenchymal injuries
? CT Angiogram

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? MRI

Penetrating injuries

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DAI

Dissection

Normal CT with non explainable

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Cervical spine fractures ? vertebral neurological deficits

artery injuries

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Guidelines for NCCT

GCS 3-8

For rest

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? get CT as soon as possible

? fall in GCS

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? Initial scan is normal then get a

? Depressed / open fractures

repeat CT if patient deteriorates ? >2 episodes of vomiting

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neurologically

? Skull base fractures

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? If initial scan is abnormal and

patient is stable, get a repeat CT ? Dangerous mechanism

24-36 hours to check

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Skul Fractures

Depressed fracture of frontal bone

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associated with haemorrhage in

frontal sinus

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Depressed comminuted fracture

with marked inward displacement of

fragments

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Intracranial Injuries

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Air

Blood

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Bone

13

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14

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Secondary effects

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Take Home Points

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? Identify the mode of injury
? Identify the pattern of injury
? Look for primary injury
? Secondary injury

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? Actionable findings

Thank you