erin o’connor neuroradiology trauma workshop. learning objectives know the appropriate imaging...
TRANSCRIPT
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Erin O’Connor
NEURORADIOLOGY TRAUMA WORKSHOP
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LEARNING OBJECTIVES
• Know the appropriate imaging work up for patients with head trauma.
• Recognize the appearance of intracranial hemorrhage on CT, specifically epidural, subdural, subarachnoid and intraparenchymal hemorrhage.
• Describe the various types and causes of brain herniation.
• Recognize the typical changes in appearance of intracranial blood products with age on CT
• See the typical appearance of diffuse axonal injury on MRI and CT
• List criteria that are used in spinal trauma to determine if the patient should have CT of the cervical spine.
• Describe some of the traumatic injuries than can be seen on a lateral c-spine radiograph
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TRAUMA TO THE HEAD
• What imaging modality would you use?
• What are you looking for?
• Why not use MRI is setting acute trauma to head?
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BRAIN CONTUSIONS
• What are they?
• Where do they typically occur?
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Figure 9. Acute trauma in a 17-year-old pregnant girl after a rollover motor vehicle accident in which she lost consciousness.
Goldman S M , Wagner L K Radiographics 1999;19:1349-1357
©1999 by Radiological Society of North America
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DIFFUSE AXONAL INJURY
• What is it? How do patients get it?
• Describe the clinical picture of DAI?
• Where does it occur?
• What is the best way to detect it on imaging?
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TRAUMA TO THE NECK
• What imaging modality would you use?
• What are you looking for?
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NORMAL CT CERVICAL SPINE
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NORMAL CT CERVICAL SPINE
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NORMAL CT CERVICAL SPINE
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• Medrol 32 mg po (or its equivalent) 12 and 2 hours prior to contrast administration.
• Some also give benadryl at time of contrast adminstration
• Cardiac pacemakers, insulin pumps, neurostimulators, cochlear implants
• Non-graphite spinal cord tongs: Graphite tongs are compatible.
• Thermodilution Swan-Ganz catheter: Local heating can result.
• Metal outside the brain and eye is NOT a contraindication: Cardiac valves, inferior vena cava filters, biliary and vascular stents, IUD's and metallic prostheses are safe, unless doubt as to positional stability.
• Plain radiography sufficient for screening.
BUT WHAT IF…
CONTRAINDICATIONS TO MRIKNOWN ALLERGIES TO CONTRAST
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