Normal findings
- • Symmetric ventricles, basal cisterns patent
- • Grey-white differentiation preserved
- • No midline shift
Common abnormal findings
Acute infarct
- • Loss of grey-white differentiation
- • Hyperdense MCA sign
- • Insular ribbon loss
Acute haemorrhage
- • Hyperdense (60-80 HU)
- • Site predicts cause: basal ganglia = hypertensive
SAH
- • Hyperdensity in sulci / basal cisterns
- • Best within 6h of ictus
EDH vs SDH
- • EDH: biconvex, doesn't cross sutures
- • SDH: crescentic, crosses sutures
Mass effect
- • Midline shift
- • Effaced sulci/cisterns
- • Herniation patterns
Interpretation tips
- • Use brain, bone and blood windows
- • Compare both hemispheres
Clinical correlation
- • Sudden severe headache + normal CT → still do LP for SAH if <12h
- • Acute infarct on CT often delayed → MRI DWI more sensitive
Common mistakes
- • Missing subtle hyperdense MCA sign
- • Calling effacement without comparing sides
Educational support only — not a substitute for clinical judgment.
