Post by @FTeranmd

Ct for Sinai Em Pearl

Using a systematic approach when reading a brain CT will make you a better doctor

Because you only see what you’re looking for. Don’t believe?


A simplified and systematic approach to the evaluation of non-contrast brain CT for the Emergency Physycian

“Blood Can Be Very Bad” 

  • B: blood:

    • Epidural hematoma

    • Subdural hematoma

    • Intraparenchymal hemorrhage

    • Subarachnoid hemorrhage

    • Intraventricular hemorrhage

  • C: cisterns (presence of blood, effacement and asymmetry)

    • Circummesencephalic (ring around the midbrain)

    • Suprasellar (star-shaped, location of circle of Willis)

    • Quadrigeminal (W-shaped at top of midbrain)

    • Sylvian (between temporal and frontal lobes)

  • B: brain

    • Assess for asymmetry or effacement of the sulcal pattern

    • Hypodensities or hyperdensities

    • Gray-white matter differentiation (early sign of ischemic stroke)

  • V: ventricles

    • Hydrocephalus

    • Blood

    • Ventricular effacement /shift

  • B: bone (make sure you change to bone widow)

    • Skull fractures

    • Pneumocephalus

Reference: FERNE / EMRA 2009 Mid-Atlantic Emergency Medicine Medical Student Symposium:

ABCs of Head CT Interpretation; Heather M. Prendergast MD, MPH.