Test your knowledge Answers Review 1 2 3

Test your knowledge Answers

Review 1. 2. 3. 4. Sutures & Fractures Bleeds Sulci & Cisterns Herniations

SUTURES & FRACTURES

This 45 day old boy has a right-sided cephalhematoma. Point to the Mendosal suture(s)

This 45 day old boy has a right-sided cephalhematoma. Point to the interparietal suture(s)

This 45 day old boy has a right-sided cephalhematoma. Point to the sagittal suture(s)

This 45 day old boy has a right-sided cephalhematoma. Point to the lambdoid suture(s)

This 45 day old boy has a right-sided cephalhematoma. Point to the posterior intraoccipital suture(s)

This 45 day old boy has a right-sided cephalhematoma. Point to the asterion

How do you explain the lines denoted by the arrows? Motion artifact.

The name of this accessory suture is: 1. Interparietal suture of the occipital bone 2. Transverse suture of the occipital bone 3. Mendosal suture 4. Posterior intraoccipital suture 5. Meridian suture Correct answer is # 2

A patient fell and underwent head CT. Point to the fracture, if there is one……

A patient fell and underwent head CT. Point to the coronal suture.

A patient fell and underwent head CT. Point to the lambdoid suture.

A patient fell and underwent head CT. What is the diagnosis? Axial CT Bone algorithm 3 D reformats Left parietal bone fracture (arrow). 3 D reformats Right

A teenager fell from a bike. Is there a fracture? No, there are 3 accessory sutures.

Identify the abnormality. Right parietal skull fracture.

Is this structure (arrow) normal or abnormal? This is a normal metopic suture.

Fracture or normal structure? Occipital bone fracture.

Which of the following is NOT a cranial suture? • a. Frontal • b. Coronal • c. Metopic • d. Mendosal • e. Meridian Correct answer is e.

BLEEDS

What type of hemorrhage is this? Epidural.

Does this patient have subarachnoid blood? 1 year old boy No, this patient has severe cerebral edema.

Does this newborn have subdural hemorrhages? No, this patient has neonatal hemoconcentration/dehydration.

Does this baby have a subdural hemorrhage? Yes.

SULCI & CISTERNS

What structure does the arrow point at? Quadrigeminal cistern.

What cistern is effaced in this image? Quadrigeminal cistern.

Explain the “three shades of gray”.

Three shades of gray Completely effaced Some sulci seen Looks normal

Which of the following is NOT a sign of cerebral edema on head CT? • a. Effaced sulci • b. Loss of gray-white matter differentiation • c. Large ventricles • d. Small basal cisterns • e. Loss of three shades of gray on a CT Correct answer is c.

What is the name of the cistern denoted by the arrow? Suprasellar cistern.

What is the name of the cistern denoted by the arrow? Suprasellar cistern.

HERNIATIONS

What type of herniation is this? External.

What type of herniation is this? Left uncal. Note asymmetrical mass effect on the cisterna ambiens (arrows).

What type of herniation is this? Central descending transtentorial 2 y. o. girl, on ECMO, fixed an dilated pupils

What normal structures are missing, and what does that mean? Effaced cisterna magna, foramina of Luschkae and Magendii- cerebellar herniation.

What type of herniation is this? Ascending transtentorial 13 y. o. girl, viral cerebellitis

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