Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Unlock access to our full Course Library and all self-paced Fellowships.
Continuing Medical Education (State CME)
Complete all of your state CME requirements in one convenient place.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Case Crunch: Rapid Case Review (Free)
Register for free live board reviews.
Dr. Resnick's MSK Conference
Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Compliance
NewTrack, fulfill, and report on all your radiologists' credentialing and licensing requirements.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
2 topics, 7 min.
8 topics, 32 min.
16 topics, 1 hr. 11 min.
Cerebellar Hematoma with Tonsillar Hernia
3 m.Intraventricular Hemorrhage
5 m.Parenchymal and Subdural Hematoma
5 m.Retroclival Subdural Hematoma
3 m.Acute on Chronic Subdural Hematoma
3 m.Midline Shift
4 m.Recurrent Subdural Hematoma
4 m.Subarachnoid Hemorrhage
5 m.Follow-up Imaging of Brain Trauma
6 m.Venous Epidural Hematoma
3 m.Venous Sinus vs. Arterial Epidural Hematomas
7 m.Evolution of Epidural and Subdural Hematomas
4 m.Diffuse Axonal Injury
9 m.Lucid Interval in Epidural Hematomas
3 m.Brainstem Hemorrhage
8 m.Pediatric Skull Fractures
7 m.6 topics, 28 min.
4 topics, 18 min.
14 topics, 1 hr. 6 min.
Secondary Traumatic Injuries
2 m.Traumatic Intracranial Dissection
5 m.Vertebral Artery Dissection, Pseudoaneurysm
6 m.Arteriographic Evaluation of Dissection
4 m.Traumatic Dissection of the MCA
4 m.Overview of Brain Herniation Types
5 m.Mechanisms of Brain Herniations
9 m.Herniation resulting in Infarction
9 m.Acute Hemorrhage on MRI
6 m.Subacute Hematoma on MRI
7 m.Chronic Hematoma on MRI
8 m.Hyperacute Hematoma on MRI
2 m.CT of Blood
3 m.Brain Trauma Summary
3 m.0:00
As I mentioned previously,
0:02
I sometimes will use the term contusion and parenchymal
0:06
hematoma interchangeably.
0:08
However, most people will think of a contusion
0:12
as a brain bruise,
0:14
which is a little bit more diffuse and less well defined,
0:17
versus a parenchymal hematoma,
0:20
which is sort of more of a consolidated area of all
0:24
the hemorrhages that can occur from contusion.
0:27
Both contusions and parenchymal hematomas can occur in the
0:33
coup area of the direct trauma or the contrecoup.
0:38
from the brain motion. And in fact,
0:41
contusions occur more commonly with contrecoup and
0:45
parenchymal hematomas generally occur
0:47
more commonly with contrecoup.
0:49
If one sees an initial CT scan that is normal
0:55
or has mere subarachnoid hemorrhage,
0:58
and then over the course of the follow up,
1:00
within the first 24 hours,
1:02
a parenchymal hematoma develops.
1:05
That delayed intraparenchymal hematoma generally has a
1:09
worse prognosis than if the patient presents initially
1:12
with the intraparenchymal hematoma because it implies
1:16
a more of a diffuse process going on in the brain.
1:19
Let's look at a few slides of cortical contusions
1:24
and contrecoup parenchymal hematomas.
1:27
So, here we have a patient on CT scan where one has an
1:32
initial evaluation, where there's just some faint blood
1:36
products that are seen in the right parietal region.
1:40
However, this patient also has a larger,
1:45
more consolidated collection of blood.
1:48
So this area I would use the term contusion,
1:53
whereas in the further inferior region, one sees a better
1:59
defined, more dense collection of hemorrhage.
2:02
And for this,
2:04
I would use the term hematoma or parenchymal
2:07
hematoma or intraparenchymal hematoma or IPH.
2:11
Again, more of the bruise versus the parenchymal hematoma.
2:18
This is another example of a patient who has a lesion
2:23
along the inferior aspect of the
2:26
anterior cranial fossa floor.
2:28
So, one notes that there is a lower density area here in
2:33
the left anterior cranial fossa region of the inferior
2:37
frontal lobe and it gets much larger as
2:42
one proceeds further superiorly.
2:45
You'll notice that there are some areas that are
2:47
hyperdense representing blood products.
2:50
So this, again, would be something that we would refer to
2:52
more as a contusion because it's not as dense and
2:56
well consolidated as a parenchymal hematoma.
Interactive Transcript
0:00
As I mentioned previously,
0:02
I sometimes will use the term contusion and parenchymal
0:06
hematoma interchangeably.
0:08
However, most people will think of a contusion
0:12
as a brain bruise,
0:14
which is a little bit more diffuse and less well defined,
0:17
versus a parenchymal hematoma,
0:20
which is sort of more of a consolidated area of all
0:24
the hemorrhages that can occur from contusion.
0:27
Both contusions and parenchymal hematomas can occur in the
0:33
coup area of the direct trauma or the contrecoup.
0:38
from the brain motion. And in fact,
0:41
contusions occur more commonly with contrecoup and
0:45
parenchymal hematomas generally occur
0:47
more commonly with contrecoup.
0:49
If one sees an initial CT scan that is normal
0:55
or has mere subarachnoid hemorrhage,
0:58
and then over the course of the follow up,
1:00
within the first 24 hours,
1:02
a parenchymal hematoma develops.
1:05
That delayed intraparenchymal hematoma generally has a
1:09
worse prognosis than if the patient presents initially
1:12
with the intraparenchymal hematoma because it implies
1:16
a more of a diffuse process going on in the brain.
1:19
Let's look at a few slides of cortical contusions
1:24
and contrecoup parenchymal hematomas.
1:27
So, here we have a patient on CT scan where one has an
1:32
initial evaluation, where there's just some faint blood
1:36
products that are seen in the right parietal region.
1:40
However, this patient also has a larger,
1:45
more consolidated collection of blood.
1:48
So this area I would use the term contusion,
1:53
whereas in the further inferior region, one sees a better
1:59
defined, more dense collection of hemorrhage.
2:02
And for this,
2:04
I would use the term hematoma or parenchymal
2:07
hematoma or intraparenchymal hematoma or IPH.
2:11
Again, more of the bruise versus the parenchymal hematoma.
2:18
This is another example of a patient who has a lesion
2:23
along the inferior aspect of the
2:26
anterior cranial fossa floor.
2:28
So, one notes that there is a lower density area here in
2:33
the left anterior cranial fossa region of the inferior
2:37
frontal lobe and it gets much larger as
2:42
one proceeds further superiorly.
2:45
You'll notice that there are some areas that are
2:47
hyperdense representing blood products.
2:50
So this, again, would be something that we would refer to
2:52
more as a contusion because it's not as dense and
2:56
well consolidated as a parenchymal hematoma.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Vascular
Trauma
Neuroradiology
Emergency
CT
Brain
© 2025 Medality. All Rights Reserved.