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HEADTRAUMAHEADTRAUMARadiology,TheSecondAffiliatedHospital,ShantouUniversity,MedicalCollege郑文斌CNStraumaClinicalFeaturesCNStraumaClinicalFeaturesNoLossofconsciousness(L.O.C)NoLossofconsciousness(L.O.C)(SDH,EDH?,NotDAI)(SDH,EDH?,NotDAI)Awakeatthescene,DelayedLOC(SDH,EDAwakeatthescene,DelayedLOC(SDH,EDH,Swelling,NotDAI)H,Swelling,NotDAI)TransientLOC-Wake-up-DelayedLOC)TransientLOC-Wake-up-DelayedLOC)(“Classic”lucidintervalforEDH)(“Classic”lucidintervalforEDH)ContinousLOCFollowingImpactContinousLOCFollowingImpact(“Classic”shearing/DiffuseAxonalinjur(“Classic”shearing/DiffuseAxonalinjury)y)CentripetalapproachousidetoinsiCentripetalapproachousidetoinsidedeScalp-hematomaScalp-hematomaCalvarium-skullfractureCalvarium-skullfractureEpidural-hematomaEpidural-hematomaSubdural-hematomaSubdural-hematomaSubarachnoid-hemorrhageSubarachnoid-hemorrhageIntraparenchymal-,contusion,edema,hemorrhagIntraparenchymal-,contusion,edema,hemorrhageeIntraventricular-hemorrhageIntraventricular-hemorrhageCalvarium-skullfractureCalvarium-skullfractureLinearLinearStellateStellateDepressedDepressedBasilarBasilarEggshellEggshellEPIDURALEPIDURALHEMATOMAHEMATOMAEPIDURALHEMATOMAEPIDURALHEMATOMAScoureofbloodScoureofbloodMenigealVessels-A,VDuralsinusMenigealVessels-A,VDuralsinuslucidintervallucidinterval（（40%pts40%pts））Bi-convex,HyperdenseBi-convex,Hyperdense-limitedbysutures-limitedbysuturesEPIDURALHEMATOMAEPIDURALHEMATOMADirecttraumatocraniumDirecttraumatocraniumFracture(90%)Fracture(90%)-LacerationofMeningealA.and-LacerationofMeningealA.andV.V.Locationis66%temporo-parietalLocationis66%temporo-parietalTemporalTemporalBone(70-80%)Bone(70-80%)Mortalityof15-30%Mortalityof15-30%EPIDURALHEMATOMA-CTEPIDURALHEMATOMA-CTBiconvexorlens-shapedBiconvexorlens-shapedhomogeneous,heterogeneous,homogeneous,heterogeneous,indicatingactivebleedingindicatingactivebleedingrarelycrossessuturesrarelycrossessuturesfracturelinefracturelineSUBDURALSUBDURALHEMATOMAHEMATOMASUBDURALHEMATOMASUBDURALHEMATOMAScoureofbloodScoureofbloodLacerationofCorticalAA.andVV.LacerationofCorticalAA.andVV.(Direct:penetratinginjury)(Direct:penetratinginjury)LargeContusions(Direct/indirect:PulpLargeContusions(Direct/indirect:PulpedBrainedBrainBridging(Cortical)VeinsBridging(Cortical)VeinsSUBDURALHEMATOMASUBDURALHEMATOMAPresentationPresentationsignificantheadtrauma,significantheadtrauma,butchronicsubdural-onlyminororrembutchronicsubdural-onlyminororremotehistoryoftraumaotehistoryoftraumaBilateralin20%adults(commoninelderBilateralin20%adults(commoninelderly),80-85%bilateralininfantsly),80-85%bilateralininfantsextensionintointerhemisphericfissure,textensionintointerhemisphericfissure,tentorialmarginsentorialmarginsbraininjuryin50%;ComplexInjury(DAI)braininjuryin50%;ComplexInjury(DAI)skullfractureinonly1%skullfractureinonly1%SUBDURALHEMATOMA-CTSUBDURALHEMATOMA-CTCrescenticinshapeCrescenticinshapeExtendsbeyondcalvarialsuturesExtendsbeyondcalvarialsuturesAcuteSDH-HyperdenseAcuteSDH-HyperdenseSubacuteSDH-Isodense(1-2weekSubacuteSDH-Isodense(1-2weeks)s)ChronicSDH-HypordenseChronicSDH-HypordenseEnhancementofveinsmaybeusefulEnhancementofveinsmaybeusefulinidentifyingisodensesubduralsinidentifyingisodensesubduralsSUBDURALHEMATOMA-MRISUBDURALHEMATOMA-MRIMaybebetterfordete...