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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.
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.
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.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
21 topics, 34 min.
Introduction to ED Practice Cases
2 m.Wk 1, Case 1 - Practice
Wk 1, Case 1 - Review
2 m.Wk 1, Case 2 - Practice
Wk 1, Case 2 - Review
3 m.Wk 1, Case 3 - Practice
Wk 1, Case 3 - Review
11 m.Wk 1, Case 4 - Practice
Wk 1, Case 4 - Review
6 m.Wk 1, Case 5 - Practice
Wk 1, Case 5 - Review
2 m.Wk 1, Case 6 - Practice
Wk 1, Case 6 - Review
4 m.Wk 1, Case 7 - Practice
Wk 1, Case 7 - Review
2 m.Wk 1, Case 8 - Practice
Wk 1, Case 8 - Review
3 m.Wk 1, Case 9 - Practice
Wk 1, Case 9 - Review
4 m.Wk 1, Case 10 - Practice
Wk 1, Case 10 - Review
2 m.20 topics, 35 min.
Wk 2, Case 11 - Practice
Wk 2, Case 11 - Review
10 m.Wk 2, Case 12 - Practice
Wk 2, Case 12 - Review
3 m.Wk 2, Case 13 - Practice
Wk 2, Case 13 - Review
3 m.Wk 2, Case 14 - Practice
Wk 2, Case 14 - Review
2 m.Wk 2, Case 15 - Practice
Wk 2, Case 15 - Review
10 m.Wk 2, Case 16 - Practice
Wk 2, Case 16 - Review
2 m.Wk 2, Case 17 - Practice
Wk 2, Case 17 - Review
1 m.Wk 2, Case 18 - Practice
Wk 2, Case 18 - Review
2 m.Wk 2, Case 19 - Practice
Wk 2, Case 19 - Review
3 m.Wk 2, Case 20 - Practice
Wk 2, Case 20 - Review
4 m.20 topics, 40 min.
Wk 3, Case 21 - Practice
Wk 3, Case 21 - Review
8 m.Wk 3, Case 22 - Practice
Wk 3, Case 22 - Review
4 m.Wk 3, Case 23 - Practice
Wk 3, Case 23 - Review
9 m.Wk 3, Case 24 - Practice
Wk 3, Case 24 - Review
2 m.Wk 3, Case 25 - Practice
Wk 3, Case 25 - Review
6 m.Wk 3, Case 26 - Practice
Wk 3, Case 26 - Review
2 m.Wk 3, Case 27 - Practice
Wk 3, Case 27 - Review
3 m.Wk 3, Case 28 - Practice
Wk 3, Case 28 - Review
4 m.Wk 3, Case 29 - Practice
Wk 3, Case 29 - Review
3 m.Wk 3, Case 30 - Practice
Wk 3, Case 30 - Review
5 m.20 topics, 39 min.
Wk 4, Case 31 - Practice
Wk 4, Case 31- Review
2 m.Wk 4, Case 32 - Practice
Wk 4, Case 32 - Review
7 m.Wk 4, Case 33 - Practice
Wk 4, Case 33 - Review
3 m.Wk 4, Case 34 - Practice
Wk 4, Case 34 - Review
5 m.Wk 4, Case 35 - Practice
Wk 4, Case 35 - Review
5 m.Wk 4, Case 36 - Practice
Wk 4, Case 36 - Review
5 m.Wk 4, Case 37 - Practice
Wk 4, Case 37 - Review
3 m.Wk 4, Case 38 - Practice
Wk 4, Case 38 - Review
6 m.Wk 4, Case 39 - Practice
Wk 4, Case 39 - Review
3 m.Wk 4, Case 40 - Practice
Wk 4, Case 40 - Review
5 m.20 topics, 41 min.
Wk 5, Case 41 - Practice
Wk 5, Case 41 - Review
6 m.Wk 5, Case 42 - Practice
Wk 5, Case 42 - Review
8 m.Wk 5, Case 43 - Practice
Wk 5, Case 43 - Review
2 m.Wk 5, Case 44 - Practice
Wk 5, Case 44 - Review
3 m.Wk 5, Case 45 - Practice
Wk 5, Case 45 - Review
7 m.Wk 5, Case 46 - Practice
Wk 5, Case 46 - Review
3 m.Wk 5, Case 47 - Practice
Wk 5, Case 47 - Review
2 m.Wk 5, Case 48 - Practice
Wk 5, Case 48 - Review
6 m.Wk 5, Case 49 - Practice
Wk 5, Case 49 - Review
4 m.Wk 5, Case 50 - Practice
Wk 5, Case 50 - Review
6 m.Interactive Transcript
Report
Report
CLINICAL INDICATION: Trauma.
TECHNIQUE: Routine brain MRI exam using standard pulse sequences pre- and post- intravenous administration of Gadolinium contrast 9.4 cc Gadovist. Noncontrast enhanced 3D time-of-flight MRA of the brain as well as pre-and post-contrast 2D and 3D MRA exam of the neck also performed with review of axial raw data and 3D/MIP images.
COMPARISON: None available
FINDINGS:
Brain MRI:
On the FLAIR sequence, diffuse increased signal intensity in the subarachnoid space bilateral cerebral hemispheres and infratentorial posterior fossa subarachnoid space demonstrated. Those hyperintensities are compatible with a subarachnoid hemorrhage. Part of those signal intensities could also be caused by hyperoxygenation intubation.
Blood product also seen in the bilateral lateral ventricles especially on the right side layering in the occipital horn. Small subdural hemorrhage along the posterior cerebral falx extending along the superior surface of the left cerebellar tentorium leaflet present with maximum thickness
measuring 4 mm. Minimal blood product also seen in the suprasellar cistern along the vermis of the cerebellum localized hemorrhagic contusion or focal hematoma involving the anterior aspect of the genu of the splenium of corpus callosum also present. Additional scattered hemorrhagic foci in the bilateral frontal and left parietal lobes also present in the gray-white matter junction. FLAIR sequences demonstrate also increased signal intensity involving the splenium of the corpus callosum. Those findings are compatible with diffuse axonal injury.
Diffusion scan demonstrates no evidence of territorial cerebral infarction, noting signal changes associated with the blood products. There is generalized cerebral edema with sweating of the cortex, for example in the right to frontal superior frontal gyrus. There is no midline shift or hydrocephalus. Ventricular size within normal range for patient's age. Edema which could represent contusion also involving the posterior midbrain bilaterally more on the left side. The central aquduct of Sylvius is patent. The postcontrast images demonstrate no enhancing mass. Mild linear meningeal enhancement in the cerebral convexity noted which could be related to the subarachnoid hemorrhage.
The cervicocranial junction is anatomic. There is no evidence of transtentorial or tonsillar herniation. Slight prominent bilateral frontal subdural CSF signal is seen measuring up to 4 mm, a nonspecific finding. However, this is within normal range. Mucoperiosteal thickening and minimal fluid in the ethmoid and sphenoid sinuses could represent underlying sinus inflammatory disease but could also be related to intubation. Mastoid air cells junction no significant fluid opacification. Multiple areas of the scalp edema from the trauma present without harsh hematoma.
IMPRESSION:
1. Intracranial hemorrhages including small subdural hematoma, subarachnoid hemorrhage, intraventricular blood, and possible hemorrhagic contusion to the posterior corpus callosum. The involvement of the corpus callosum and multiple hemorrhagic foci at the gray-white matter junction is compatible with diffuse axonal injury.
2. Mild generalized cerebral edema present with no evidence of herniation or midline shift. No evidence of hydrocephalus. No evidence of acute territorial cerebral infarction.
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Trauma
Neuroradiology
CT
Brain
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