Neuroradiology

Sony Sutrisno
Department of Radiology
Krida Wacana Christian
University

CT- Scan
Axial / Sagital / Coronal
Isodens
Hypodens
Hyperdens
Enhancement

Sagital

Coronal

Axial

Hypodens

Hyperdens

Enhancement

Anatomy

CC = Corpus Callosum
L = Ventricle Lateral
C = Nucleus Caudatus
G = Globus Pallidus
P = Putamen
3 = Third Ventricle
T = Thalamus
A = Auditory Radian
O = Optic Radian

Anatomy

Cerebro Spinal Fluid

What GP should know?

SETTINGS
Stroke
Non-trauma
Ischemic
Hemorrhagic
Intracerebral
Hemorrhage
(ICH)
Subarachnoid
Hemorrhage
(SAH)
SOLs
Neoplasm
Infection
(Abscess)

Trauma
Skull fracture
Contusio
Subdural Hematoma
(SDH)
Epidural Hematoma
(EDH)

Edema Cerebri

R
T
S

K
O

!
E

ISCHEMIC
The presence and extent of the ischemic penumbra
are time-dependent, but are especially patientdependent
Golden Period : generally less than 6 hours, less
than 3 hours is better)
As basis to do or not to do Thrombolytic therapy
Imaging modalities : CT-scan & MRI (better)
MRI (DWI seq) more sensitive (esp. hyperacute
setting)
Conventional Radiography has NO ROLE!

Infarct / Ischemic stroke

HEMORRHAGIC
Spontaneous hemorrhage: 10-15% of
stroke (US)
Typically parenchymal, but also may
involve primarily subarachnoid spaces
(SAH)
Spontaneous SAH mostly caused by
aneurismal rupture
Imaging modalities : CT-scan (primary)
and MRI
CT-scan : rapid, widely available and
sensitive (for acute bleeding, appear as

Hemorrhagic Stroke

EPIDURAL
HEMATOMA

Rupture of meningeal
artery
Imaging of choice is CT-scan,
appears as convex
hyperdense area
Beware of herniation!

Epidural Hematoma

SUBDURAL
HEMATOMA

Rupture of bridging vein: Imaging of choice is CT-scan,

appears as concave hyperdense area

Subdural Hematoma

Subarachnoid Hemorrage

Intraventricular
Hemorrhagic

Brain and Bone Window

SPACE OCCUPYING
LESIONs (SOL)
The disease itself is not true emergency
Could be caused by neoplasm or infection (abscess)
Mass effect could cause herniation &

hydrocephalus!
the emergency part
Malignant neoplasm (ex. GBM) often has greater
mass effect than benign one (ex. meningioma)
Imaging modalities : CT or MRI (better) +
CONTRAST!
Contrast media gives better mass delineation &
characterization

Type of Herniation

Hydrocephalus
Communican
Non communican
CSF Flow

Hydrocephalus

Hydrocephalus

Meningitis

Abcess

EXAMPLE

Schedel AP Lateral

Thank You