Brain CT Clinical Guide

To competently read a computed tomography (CT) brain scan, you need to recognize abnormalities that are additions (e.g., hemorrhage and masses), as well as the absence of normal structures. This is because, in many patients, the loss of normal anatomy is the only manifestation of significant disease evident on brain CT. In the articles of this chapter, we review how to maximize your ability to recognize subtle disease by identifying key normal structures on every scan, and how to optimize the appearance of CT images on a computer monitor.

Head trauma is among the most common indications for brain computed tomography (CT) imaging in the emergency room. In the articles included in this chapter, you will see case studies involving the types of brain injuries you can expect to find in trauma patients. In the last article, we also describe common pitfalls on brain CT imaging that can lead to unnecessary imaging or misdiagnosis.

In the past few decades, optimal care of stroke patients has changed significantly. Currently, emergency brain CT imaging provides much of the essential information necessary for decisions regarding urgent treatment. These interventions have the potential to profoundly alter the outcome for these patients. The findings on brain computed tomography (CT) in these cases can be surprisingly subtle, despite the magnitude of the patient’s symptoms. This chapter’s articles will show you what to look for on CT in patients with acute neurological deficits so that you can improve your ability to recognize important findings.

Whenever a patient presents to the emergency room for a severe headache, recognition of even the smallest amount of hemorrhage on brain CT will significantly alter the care of that patient. After reviewing the articles in this chapter, you will be able to recognize non-traumatic hemorrhages on computed tomography (CT) within the brain, the ventricles, and subarachnoid space, and learn how hemorrhages can lead to the diagnosis of an unsuspected pathology.

Brain tumors are frequently first detected on brain computed tomography (CT) scans. The case studies presented in this chapter’s articles demonstrate how the location of the mass can influence your prediction of the type of tumor. We also review the limitations of CT, and how magnetic resonance imaging (MRI) is used alongside brain CT to establish the most likely tumor diagnosis.

Seizures are a common indication for computed tomography (CT) imaging of the brain. In the articles of this chapter, you will see case studies featuring diseases that can present initially with seizures and discover how to appropriately use brain CT imaging to establish the diagnosis in patients with both newly presenting seizures and epilepsy.

Deep to the brain cortex and white matter lie the thalami and basal ganglia. While the abnormalities that result in seizures usually reside in the cortex, many other diseases involve these deep structures, sometimes symmetrically. After reviewing the articles in this chapter, you’ll be able to recognize abnormalities of the thalami, basal ganglia, and white matter, and discover common causes for their appearance on brain computed tomography (CT).

While the brain is most often the organ of interest on computed tomography (CT) imaging, the skull is always included on these scans. It is important to be able to recognize traumatic injuries of the skull, but also unsuspected benign and malignant diseases that may involve the skull bones and skull base. The case studies presented in this chapter’s articles will help you to recognize these skull abnormalities on brain CT, which is important since their presence may significantly influence treatment and follow-up care.