Neuroimaging clinics of North America
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Assessment of the orbit for orbital trauma is best achieved expeditiously with CT in the determination of extent of injury and the presence of foreign body. MR imaging has a limited role but is valuable in examining the optic nerve and globe for injury and has proven to be an adjunct modality in the assessment of orbital injury.
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The imaging of head trauma has been one of the fundamental cornerstones of neuroradiology. As the practice of neuroimaging has matured, great strides have been made in the diagnostic as well as prognostic armamentarium available to physicians. ⋯ Furthermore, these new tools are allowing the imaging specialist to function not only as an interpreter of what is seen but as a 21st century radiographic oracle. We present a comprehensive review of the imaging findings of sequlae of traumatic brain injury and the growing correlation of new neuroimaging techniques and neurotraumatic outcomes.
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This article reviews the essential primary and secondary injuries attributable to traumatic brain injury (TBI) which causes one third of all injury deaths in the United States. Motor vehicle crashes, falls, assaults, guns, sports, and recreational activities are the major causes of TBI. Secondary peak incidences of TBI occur in infants and children and the elderly. ⋯ Radiologists must accurately interpret the CT and MR images of injured patients. Forensic pathologists have long appreciated the characteristic focal lesions, such as coup and contracoup contusions, that occur in falls or vehicle accidents, but the understanding of diffuse injuries has been more elusive. Understanding the nature of the focal and diffuse injuries is critical to understanding the morbidity and mortality of brain injury.
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Facial trauma is a commonly encountered injury in the emergency department. Facial fractures can be categorized into limited, transfacial, and smash fractures. ⋯ Smash fractures are comminuted fractures that do not follow classical facial fracture patterns. Depending on the severity of injury, treatment may be conservative or surgical. [figure: see text] Computed tomography is superior to conventional radiography, tomography, and MRI in detecting facial fractures, defining their direction, extent, and displacement.
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In addition to its inability to predict pressure elevation accurately, head CTs done serially even at 12-hour intervals, cannot adequately portray the dynamic, sometimes rapid evolution (usually growth) of a traumatic hematoma. These limitations aside, CT scanning provides adequate imaging for rational surgical treatment of head injury. Whether for monitoring, diagnostic, or therapeutic purposes, cranial procedures for traumatic pathology are guided by CT.