KEY FACTS Terminology Direct carotid cavernous fistula (CCF), high-flow CCF Single-hole tear/transection of cavernous internal carotid artery (ICA) with arteriovenous shunt into cavernous sinus (CS) Imaging General features Proptosis, dilated superior ophthalmic vein (SOV) and CS, extraocular muscle enlargement Skull…
KEY FACTS Terminology Dissection Intramural hematoma extends along vessel wall Dissecting aneurysm Dissection + aneurysmal dilation contained by adventitia Pseudoaneurysm Lumen contained by thrombus outside vessel wall Imaging Location Often adjacent to falx, skull, tentorium, or region of significant motion…
KEY FACTS Terminology Dysautoregulation/second impact syndrome Repeated head trauma within “window of vulnerability” before brain recovers from initial concussive injury May cause catastrophic brain swelling Imaging Thin, acute subdural hematoma (aSDH) Disproportionate mass effect – Midline (subfalcine) shift more than…
KEY FACTS Terminology Brain death (BD); death by neurological criteria (DNC) Complete, irreversible cessation of brain function Imaging No flow in intracranial arteries or venous sinuses No intravascular enhancement on CT or MR Light-bulb sign on radionuclide study Diffuse cerebral…
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KEY FACTS Terminology Brain displaced from 1 compartment into another Imaging Subfalcine herniation Cingulate gyrus displaced under falx Lateral ventricle compressed/displaced across midline Contralateral ventricle dilated Unilateral descending transtentorial herniation (DTH) Temporal lobe displaced medially into incisura Encroaches on, then…
KEY FACTS Terminology Subcortical injury (SCI): Deep diffuse axonal injury lesions of brainstem, basal ganglia, thalamus, and regions around 3rd ventricle Intraventricular hemorrhage (IVH): Hemorrhage within ventricular system Choroid hemorrhage (CH): Hemorrhage localized to choroidal plexus Imaging SCI: FLAIR most…
KEY FACTS Terminology Traumatic axonal stretch injury Imaging General features Can be hemorrhagic or nonhemorrhagic – Microbleeds important imaging marker for diffuse axonal injury (DAI) – Intraventricular hemorrhage correlates with DAI Location – Subcortical/deep white matter (WM), corpus callosum –…
KEY FACTS Terminology Brain surface injuries involving gray matter and contiguous subcortical white matter Imaging Best diagnostic clue: Patchy hemorrhages within edematous background Characteristic locations: Adjacent to irregular bony protuberance or dural fold Anterior inferior frontal lobes and anterior inferior…
KEY FACTS Terminology Blood within subarachnoid spaces Contained between pia and arachnoid membranes Imaging High density on CT, hyperintensity on FLAIR Top Differential Diagnoses Nontraumatic SAH Meningitis: Cellular and proteinaceous debris Carcinomatosis meningitis Pseudosubarachnoid hemorrhage Gadolinium administration High inspired oxygen…