A useful mnemonic which is used to read an emergency head CT scan is:
Using a systematic approach will help to ensure that significant neuropathology will not be missed.
- look for asymmetry or effacement of the sulcal pattern, gray-white matter differentiation (including the insular ribbon sign), structural shifts and abnormal hypo (e.g. air, edema) or hyperdensities (e.g. blood, calcification).
- look for skull fractures (especially basilar) in bone windows (soft tissue swelling, mastoid air cells and paranasal sinuses fluid in the setting of trauma should raise the possibility of a skull fracture; intracranial air means that the skull and the dura have been violated somewhere).