Dr Khanak Nandolia Dr Ankit Sharma Learning Objectives To learn mechanisms of various TBI To identify common TBI To identify complications of TBI Epidemiology 10 million people suffer from TBI every year globally ID: 933912
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Imaging Of Traumatic Brain Injury
Dr. Khanak Nandolia
Dr. Ankit Sharma
Slide2Learning
Objectives
To learn mechanisms of various TBI
To identify common TBI
To identify complications of TBI
Slide3Epidemiology
10 million people suffer from TBI every year globally
10% are fatal
5-10% sustain chronic disabilities
20-25% have moderate disabilities
Slide4Modes of injury
Missile / Penetrating injury
Non missile injury – road traffic accidents, falls.
Ground level falls in children and elderly adults
Slide5Classification
Primary injury
occurs at the time of injury
Fractures
Intracranial hematoma
Contusions
Lacerations
DAI
Secondary injury
Due to mass effect
Herniations
Edema
Ischemia
Vascular injuries
Slide6Modalities
Radiographs / X-rays
Can only identify fractures
Intracranial injuries can not be detected
NCCT
Preferred screening tool
Bone injuries
Parenchymal injuries
Slide7CT Angiogram
Penetrating injuries
Dissection
Cervical spine fractures – vertebral artery injuries
MRI
DAI
Normal CT with non explainable neurological deficits
Slide8Guidelines for NCCT
GCS 3-8
get CT as soon as possible
Initial scan is normal then get a repeat CT if patient deteriorates neurologically
If initial scan is abnormal and patient is stable, get a repeat CT 24-36 hours to check
For rest
fall in GCS
Depressed / open fractures
>2 episodes of vomiting
Skull base fractures
Dangerous mechanism
Slide9Skull Fractures
Slide10Depressed fracture of frontal bone associated with haemorrhage in frontal sinus
Depressed comminuted fracture with marked inward displacement of fragments
Slide11Slide12Intracranial Injuries
Slide13Air
Blood
Bone
13
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Slide15Slide16Slide17Slide18Slide19Slide20Slide21Slide22Slide23Slide24Slide25Slide26Slide27Slide28Slide29Slide30Slide31Slide32Slide33Slide34Slide35Slide36Slide37Secondary effects
Slide38Slide39Slide40Slide41Slide42Slide43Slide44Slide45Slide46Slide47Slide48Slide49Take Home Points
Identify the mode of injury
Identify the pattern of injury
Look for primary injury
Secondary injury
Actionable findings
Slide50Thank you