Neuroradiology
Approach to Head CT
Rapid Assessment of CT head or
Do I need to call a Neurosurgeon
NOW!!!
1.
2.
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6.
7.
Is the brain in the middle of the head?
Do the 2 sides of the brain look alike?
Can I see the smile and the pentagon?
Is the 4th ventricle in the midline and symmetrical?
Are the lateral ventricles huge with effaced sulci?
+ the Anderson additional questions
Are there any abnormal white things inside the skull?
Are there any abnormal black things inside the skull?
1 – 5 From Brant & Helms “Fundamentals of Diagnostic Radiology” 2nd ed.
Is the brain in the middle of the
head?
YES
NO
Do the 2 sides of the brain look
alike?
YES
NO
The Smile
• Quadrigeminal Plate Cistern
The Pentagon (or star)
• Suprasellar Cistern
No Smile, No Pentagon
No Good!!
th
4
Ventricle
th
4
Ventricle
Are the lateral ventricles huge
with effaced sulci?
Ventriculomegaly
2 different 30ish year old patients