1. Systematic Approach to Reading a Non-Contrast Head CT Scan

2. Systematic Approach Assess each component of the intracranial cavity
Blood
Brain
Bone
CSF

3. Blood Epidural Hematoma (EDH) Subdural Hematoma (SDH)
Arterial Bleed: High-Pressure “Lens” Shape
Middle Meningeal Laceration (Skull Fracture)
Subdural Hematoma (SDH)
Venous Bleed: Low-Pressure “Crescent” Shape
Acute / Chronic (Is Patient Anticoagulated? Alcoholic?)
Subarachnoid Hemorrhage (SAH)
Traumatic / Aneurysmal
Intraventricular Hemorrhage (IVH)
Intraparenchymal Hemorrhage (IPH)
Hypertensive Basal Ganglia or Lobar
Cerebral Contusion “Coup-Contrecoup”

4. EDH

5. SDH: Acute/Chronic

6. SAH (Aneurysmal)

7. IVH

8. IPH

9. IPH

10. Contusion
Coup (Red)
Contrecoup Contusion (Orange) (at 180 degrees)

11. Brain Symmetry (of Hemispheres)
Hyper-/Hypodensities (Masses, Edema, Stroke)
Grey/White Matter Border
Lost Grey-White Differentiation in Anoxic Injury
Midline Shift
Gyri/Sulci
Wide Sulci: Atrophy
Effaced Sulci: Edematous “Tight/Swollen” Brain
Pneumocephalus (Air in Brain)
Open Fracture (or Craniotomy)
Fracture through Sinus

12. Mass

13. Midline Shift

14. Sulci/Gyri: Atrophy/Edema

15. Bone Fractures Especially Temporal Bones Sinuses & Air Cells
Look for Air-Fluid Levels

16. Pneumocephalus

17. Temporal Bone Fracture

18. CSF: Ventricles & Cisterns
Blood in Ventricles?
Effacement/Asymmetry: Compression from Mass/Hematoma
Hydrocephalus
Atrophy (“Ex Vacuo”)
Communicating / Obstructive Hydrocephalus
If Obstructive, Where?
Look at Lateral, 3rd, and 4th Ventricles
Cisterns
Look for Effacement (Edema/Early Herniation)
Look for Blood

19. Cisterns/Effacement

20. Ventricles/Hydrocephalus