Introduction to CNS Imaging, Trauma

(Left) NECT scan of a prisoner

imaged for head trauma

shows no gross abnormality.

(Right) Scout view in the same

patient shows a foreign object ﬈ (a handcuff key) in the

prisoner's mouth. He faked the

injury and was planning to

escape, but the radiologist

alerted the guards and

thwarted the plan. This case

illustrates the importance of

looking at the scout view in

every patient, especially those

being imaged for trauma.

(Courtesy J. A. Junker, MD.)

(Left) Axial NECT scan in a 64-

year-old woman with a

ground-level fall shows only a

small linear hyperdensity

﬈

adjacent to the falx cerebri

and torcular Herophili. The

scan was initially considered

normal. (Right) Coronal NECT

in the same patient was

reformatted from the axial

source data. Note thin

peritentorial acute subdural

hematoma ﬇, nicely

contrasted with the nearly

invisible, normal left side of

the tentorium ſt.

(Left) NECT scan in a 3-yearold boy with severe head

trauma shows brain swelling

with obliteration of all sulci

and subarachnoid cisterns,

intracranial air

("pneumocephalus") ſt, and

subarachnoid hemorrhage ﬇.

(Right) Bone CT in the same

patient shows the importance

of determining why

intracranial air ſt is present.

Multiple skull fractures are

present, including a

longitudinal fracture through

the aerated right temporal

bone st.

Trauma, and Stroke

Brain: Pathology-Based Diagnoses: Malformations,

35