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Brain imaging course – Unknown case 7 and conclusion скачать в хорошем качестве

Brain imaging course – Unknown case 7 and conclusion 3 months ago

neuroradiology

radiology

imaging

CT

CTA

angiogram

subarachnoid hemorrhage

SAH

aneurysm

anterior communicating artery

coil embolization

vasospasm

hypertension

basal cisterns

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Brain imaging course – Unknown case 7 and conclusion
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Brain imaging course – Unknown case 7 and conclusion

This video is the 7th and final unknown case that goes with the brain imaging capstone course. At the end, we wrap up what we’ve learned. If you want to follow along, you can find all the images for the case at the brain capstone website: https://learnneuroradiology.com/brain... 0:00 Introduction 37 year-old man presenting with the worst headache of his life 0:31 Interactive review – noncontrast CT In this case, there is a noncontrast axial and coronal CT. On the axial images, you see some subarachnoid blood in the prepontine cistern and 4th ventricle which increases as you go superior. There is subarachnoid blood in the sylvian fissures and interhemispheric fissure. There is also enlargement of the ventricles, or hydrocephalus. The coronal CT confirms these findings. 2:27 Interactive review –CT angiogram (CTA) There is an axial CT angiogram and we need to look for causes of subarachnoid hemorrhage. It’s important to follow a search pattern so you don’t miss important findings or fall victim to satisfaction of search. The identifies a potential aneurysm of the anterior communicating artery (A-comm), where there is a 4 mm rightward directed outpouching. The coronal images confirm the finding. We want to make sure to look at our vertebral and basilar arteries too though so we don’t miss any findings. 4:32 Imaging recap A few key images show the hemorrhage centered in the basal cisterns with anterior involvement. Select images from the CTA show the aneurysm of the ACA. Your first question is what is the cause of the subarachnoid hemorrhage? In this case it is a cerebral aneurysm rupture. Angiographic images show the outpouching before and after it is coiled through endovascular treatment. Your second question is what is a common complication of subarachnoid hemorrhage? Vasospasm is a very common complication which occurs 4-10 days after the onset of hemorrhage and can result in narrowing of vessels and possible ischemia. 6:29 Diagnosis – Subarachnoid hemorrhage and aneurysm rupture This is a case of subarachnoid hemorrhage from aneurysm rupture. Hypertension, drug use, trauma, and family history are all risk factors. The pattern of aneurysm can help you identify where the aneurysm might be. Some locations are more common for aneurysms. 90% of aneurysms are anterior, with common locations being the Acomm, ICA terminus, and MCA. Other common locations are the basilar tip and PICA. 9:10 Recap What have we learned? We learned the value of different imaging modalities, including CT, CTA, and MRI, and when to choose them. CT is a screening exam to identify severe pathology, with MRI used to get a more detailed examination of the brain parenchyma. Thanks for tuning in to all the cases as part of the brain course. There are a total of 7 cases you can review on your own at the website and explanations will be posted here. Be sure to check back in for additional videos in the future or check out the website at https://www.learnneuroradiology.com

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