Imaging intracranial hemorrhage – systematic approach

This section introduces a systemic approach to imaging intracranial hemorrhage.

Specifically, what features should you be thinking about when you are imaging hemorrhage?
– How many hemorrhages there are
– Where is the hemorrhage
– What is the age of the patient
– What else is going on

Also, what should you do next when imaging a hemorrhage? Your tools include
CT angiography
MR/MR angiography
Catheter angiography

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology or may see patients with intracranial hemorrhage or stroke.

Check out the full Youtube playlist to see the entire lecture.

Imaging intracranial hemorrhage – imaging appearance and evolution

This section covers the general imaging appearance of intracranial hemorrhage.

On CT, acute hemorrhage is initially hyperdense due to high protein content within serum and red blood cells. Over time, proteinaceous contents will be cleared and the hemorrhage will become less dense.

The MRI appearance of hemorrhage is dominated by the status of hemoglobin. oxyhemoglobin is first converted to deoxyhemoglobin and then methemoglobin, all which have slightly different MR properties. It’s complex, but there are stupid mnemonic devices you can use to help.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology or may see patients with intracranial hemorrhage or stroke.

Check out the full Youtube playlist to see the entire lecture.

Imaging Intracranial hemorrhage – introduction

This is the introduction chapter to a review of imaging intracranial hemorrhage. This lecture will cover general imaging appearance of intracranial hemorrhage, how it evolves over time, and a strategic approach to diagnosing causes of intracranial hemorrhage. Aneurysmal subarachnoid hemorrhage and traumatic intracranial hemorrhage are not really covered much here, with the emphasis on intraparenchymal hemorrhage.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology or may see patients with intracranial hemorrhage or stroke.

Check out the full Youtube playlist to see the entire lecture.

Head CT (computed tomography) radiology search pattern

For those aspiring radiologists out there, has anyone ever explained to you what you should do when you sit down at the PACS station to look at a head CT?

For those non-radiologists out there, have you ever wondered what exactly is going through a radiologists mind as they look through the images?

This video attempts to demystify a lot of that by showing exactly how you might sit down and look at a head CT on your own. It starts from the beginning and shows you what kind of images you have and where to begin as you scroll through.

The level of this video is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology. It may also be of interest to those with an interest in radiology who are simply curious to learn more about radiology.

See this and other videos on our Youtube channel.

Basic Neuroradiology – Chapter 10 – Harm is Rare

Academic residencies have a number of safety valves that mean even when you do make mistakes, there are people there to back you up. Plus residents make mistakes about as often as faculty!

For more detailed information about resident miss rates, check out our publication reviewing a large number of independent resident studies. 

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.

Basic Neuroradiology – Chapter 9 – Don’t argue

While it can seem like a good idea to argue with ordering providers, it seldom pays off in the long run. You’re essentially playing the odds that you are always right, and radiologists read A LOT of studies. Eventually you’ll be embarrassed at yourself.

Plus, much of the arguing comes from inner insecurity about having to read more studies or a complex study that you don’t understand. Be confident, advise ordering clinicians to the best of your ability, and help them.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.

Basic Neuroradiology – Chapter 8 – Edges of the Study

Don’t forget to look at the edges of the study. Sometimes the most important finding is there.

It’s a common mistakes radiologists to miss findings that aren’t in the center of the images or aren’t in the regular search pattern, so you have to make it part of your search pattern. For brains, you need to look at the skull base and the bones. For spines, be sure to look at the soft tissues of the neck, lungs, and abdominal organs and soft tissues.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.

Basic Neuroradiology – Chapter 7 – Satisfaction of Search

Don’t find one abnormality and stop looking. Sometimes the most important abnormality is the second one… or third… In fact, it’s an old saying that if you’re working at the VA and you only found one cancer, keep looking for the second one. 

While that is somewhat in jest, one of the most common mistakes for starting radiologists is not continuing their search pattern after finding abnormal findings. Look at every study the same and don’t get too distracted by some findings which can be very impressive. Sometimes it may even help you to finish your search pattern before describing the obvious findings.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.

Basic Neuroradiology – Chapter 6 – Learn from your misses

While it’s not fun to miss a finding, you can benefit from it when you learn to improve in the future. Plus, it looks really bad when you miss the same finding over and over again! Build your misses into your search pattern and look for areas which can be trouble spots. On the brain, that’s often the posterior fossa, middle cranial fossa, and skull base. However, each person will likely have their own individual weak spots. Keep track of your misses and learn from them.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.

Basic Neuroradiology – Chapter 5 – Follow the clues

Sometimes, useful clues on the image which are themselves unimportant can direct you to the useful findings. For example, soft tissue swelling on a head CT is not particularly important. However, it may lead you to a more significant underlying finding, like a hematoma or skull fracture. Use those clues to be better than the average radiologist.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in basic concepts of neuroradiology.