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Findings:
•Lens shaped hyperdense area indicates epidural hematoma
•Midline shift
•Some dark non-clotted blood is seen also
a
Findings:
•Hyperdense perimesencephalic cisterns indicate subarachnoid blood
•Narrowed midbrain worrisome for diffuse cerebral edema
Dx: Subarachnoid hemorrhage
•Hyperdense perimesencephalic cisterns indicate subarachnoid blood
•Narrowed midbrain worrisome for diffuse cerebral edema
Findings:
•Subdural fluid, hypodense bilateral (flattened gyri and no crossing vessels seen)
•Not subarachnoid fluid
•Arachnoid cyst seen at lower level in temporal fossa
Findings
•Square shape frontal horns is seen with absent septum pellucidum
•Clefts in the brain bilateral, left > right indicates schizencephaly
Dx: Profound hypoxic ischemic injury in a child
•With not so severe HIE, there is often watershed injury with preservation of thalami (due to preferential shunting of oxygenated blood to thalami)
•With total anoxia or prolonged hypoxia, the shunting does not work and the thalami may take the biggest hit
•This worst situation is with both involved as in this child
Findings:
•Heterogeneous lesion in the posterior fossa with high and low density indicating partially clotted blood
•Linear periventricular high density and at the caudothalamic grooves indicates germinal matrix still present (arrowhead)
•Cortex also high density due
to extreme prematurity
Findings
•Prominence of the CSF spaces around the brain
•There is no flattening of the gyri and there are tiny vessels in the CSF indicating it is the subarachnoid, not subdural space
Dx: Benign enlarged subarachnoid spaces
•Seen most 3m - 3yrs
•Presents with macrocephaly in an otherwise healthy child
•Resolves spontaneously
•Associated with slight increased risk of subdural bleed
Dx: Normal prominent venous sinuses
•Can mimic venous sinus thrombosus
•Should do contrasted exam if unsure and if not thrombus will see enhancement
Hx: Baby fell of couch
•Hyperdense subdural blood on left side indicates recent trauma
•Loss of left side sulci due to subdural fluid
Findings:
a
Mixed density left subdural blood with left to right shift
Left loss of gray white differentiation and shift left to right of midline
Dx: Hyperacute subdural hematoma
a
Mixed density indicates blood has not had time to clot yet
Must distinguish from acute on chronic SDH, in which there is there is not acute mass effect
Requires urgent surgical intervention
Findings:•Bilateral high density in the thalami
•Prominent internal cerebral veins (arrowhead)
•Focus of right frontal horn intraventricular blood (arrow)
Dx: Venous hemorrhage due to venous sinus thrombosis
•Internal cerebral vein thrombus, most common in babies, classically causes bilateral thalamic ischemia/hemorrhage
Findings
•CSF space that connects with 4th ventricle (arrow)
•Hypoplastic cerebellum and large retrocerebellar fluid collection
•Hyrocephalus
•Macrocephaly
Dx: Dandy Walker malformation
•DW cyst has NO cerebellar vermis
•DW variant has some vermis
•DW malformation includes DW cyst and variant
•On CT hard to know if there may be a little vermis, so just say DWM and leave specifics to MRI reports