1. Head Injury & Head CT
Paleerat Jariyakanjana, MD
Faculty of Medicine, Naresuan University
25 Oct 2013

2. 2008

3. head injured patient
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

8. Low risk
Moderate risk
Asymptomatic Vomiting
GCS 15
Loss of consciousness
No headache Diffuse headache
Post-traumatic amnesia
Vertigo
Large contusion / laceration /
subgaleal hematoma
Age <2 or ≥60 yr
On anticoagulant or antiplatelet
Alcohol intoxication with GCS
14
Multiple trauma
Child abuse
Sign of base skull fracture
Observe at
home with
instruction
sheet
High risk
Skull fracture
GCS 13-14 without
intoxication
Neurological deficit
Penetrating skull injury
Post-traumatic seizure
Consult neurosurgeon + CT scan

9. HEAD CT

10. Trauma

11. Trauma

12. Trauma

13. Trauma

14. Nontrauma

16. Acute stroke
 Cytotoxic edema
 Loss of gray/white matter differentiation
• Insular ribbon sign
• Disappearing basal ganglia sign
 Effacement of cortical sulci
 Subtle low attenuation
 Middle cerebral artery sign

17. Hypoattenuating brain tissue

18. Obscuration of the lentiform nucleus

19. Insular Ribbon sign

20. Dense MCA sign

21. Non-trauma

22. Basal ganglia haemorrhage

23. Nontrauma

24. Nontrauma

25. ANY QUESTIONS?