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The modality of choice is computed tomography (CT scan), without contrast, of the brain. This has a high sensitivity and will correctly identify 98.7% of cases within six hours of the onset of symptoms. [31] A CT scan can rule out the diagnosis in someone with a normal neurological exam if done within six hours. [32]
CT scan (computed tomography) of the brain (without any iodinated contrast), is the initial imaging choice because of its high speed, good accessibility in hospitals, high sensitivity in detecting brain injuries or brain diseases, thus helping to triage patients in emergency department in a timely manner and urgent neurosurgical intervention ...
CT images of the head are used to investigate and diagnose brain injuries and other neurological conditions, as well as other conditions involving the skull or sinuses; it used to guide some brain surgery procedures as well. [2] CT scans expose the person getting them to ionizing radiation which has a risk of eventually causing cancer; some ...
Intraparenchymal hemorrhage can be recognized on CT scans because blood appears brighter than other tissue and is separated from the inner table of the skull by brain tissue. The tissue surrounding a bleed is often less dense than the rest of the brain because of edema, and therefore shows up darker on the CT scan. [30]
If the CT scan is negative but a ruptured aneurysm is still suspected based on clinical findings, a lumbar puncture can be performed to detect blood in the cerebrospinal fluid. Computed tomography angiography (CTA) is an alternative to traditional angiography and can be performed without the need for arterial catheterization.
[13] [16] Bleeding may occur due to a ruptured brain aneurysm. [13] Diagnosis is typically based on a physical exam and supported by medical imaging such as a CT scan or MRI scan. [9] A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan. [10]
In contrast, epidural hematomas are usually caused by rips in arteries, resulting in a build-up of blood between the dura mater and the skull. The third type of brain hemorrhage, known as a subarachnoid hemorrhage (SAH), causes bleeding into the subarachnoid space between the arachnoid mater and the pia mater. SAH are often seen in trauma ...
CT Perfusion scan of the brain. CT perfusion imaging is a specific form of CT to assess flow through blood vessels whilst injecting a contrast agent. [21] Blood flow, blood transit time, and organ blood volume, can all be calculated with reasonable sensitivity and specificity. [21]
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