Fig. 5.37 Traumatic subarachnoid haemorrhage. This is best seen as 'fingers' of high density in the sulci peripherally. The brain is very swollen and oedematous with loss of distinct differentiation between grey and white matter. The brain is of reduced density.

differentiation between grey and white matter. It is important to view CT scans of the head performed for trauma on a number of different window settings. Skull fractures are much more apparent on bone windows (see Figs 5.39 and 5.40) than on the corresponding soft tissue windows. In the trauma setting it is important to search for air within or surrounding the brain as this is indicative of a skull fracture (Figs 5.41 and 5.42). More subtle appearances on CT can, nevertheless, be indicative of severe injury and are associated with considerable morbidity. Figures 5.43 and 5.44 demonstrate

Fig. 5.39 CT head following motor cycle accident (no helmet). There is a depressed skull fracture with a small pocket of air within the cranium. The bony anatomy is most clearly visualised on bone windows.
Fig. 5.40 CT head displayed on normal brain window (same scan as Fig. 5.39) to demonstrate the difference between brain and bone window. The brain window is clearly superior for demonstrating the brain contusion and haematoma.

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