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What does my CT scan report indicate?

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Posted on Fri, 29 Jul 2016
Question: Good day Dr Spaho

Thank you for recent view with respect to https://drive.google.com/folderview?id=0B90glucIcidFdlBfU2ExOENUa28&usp=sharing.

The older CT scan from 1.5 years prior has been traced, which was taken within days of another incident following 15 XXXXXXX 2015 involving violence.

The DICOM set with CT scan for 15 XXXXXXX 2016: https://drive.google.com/open?id=0B90glucIcidFeFdGVDBnWW5yQ0E as 0000-0000.zip

With reference to the fracture identified on 0000 near the top center back of the head:

i) Does the fracture appear in this older CT scan of the same patient?
ii) The indentation was noted after the 15 XXXXXXX 2015 incident. Can the CT scan confirm if the fracture was a result of the incident that occurred days within the scan having been taken?
iii) Are there any other signs of trauma, e.g. swelling, etc from the older CT scan 0000-0000?

xxxxxx
doctor
Answered by Dr. Erion Spaho (23 minutes later)
Brief Answer:

Your questions answered below.


Detailed Answer:
Hello xxxxx and thanks for asking me directly.

The fracture appears to be present at the older CT too (16-01-2016).

Since the fracture is evident on the CT scan done at 16-01-2016, it is obvious that it was caused before the CT was done and indentation is the result of it.

Minor signs of subcutaneous tissue swelling are evident too.

Hope this helps.

Feel free to ask us if you have other questions.

Greetings.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Erion Spaho (3 hours later)
For clarity there are 2 CT scans taken approx 1.5 years apart.

1) 1 Jul, 2016 (0000-0000, as in prior thread)
2) 16 XXXXXXX 2015 (0000-0000, for this thread)

As far as it is understood, with respect to "ossification", or..., can one confirm whether or not the fracture was caused within days of scan 0000-0000 from XXXXXXX 2015, i.e. a "fresh" fracture, or from an event say months or years prior that?

Is it possible to clarify "minor signs of subcutaneous tissue swelling" i.e. where these might be evident?

xxxxx
Good day Dr Spaho

A message was posted after the introduction, before your first response, for a correction as: "DICOM set with CT scan for 15 XXXXXXX 2016" should read:..."15 XXXXXXX 2015".

...but does not appear on the thread.

doctor
Answered by Dr. Erion Spaho (17 hours later)
Brief Answer:
CT findings explained below.

Detailed Answer:
Welcome back.

0000-0000 is not a CT scan, it contains only skull, abdomen and chest x-ray films.

0000-0000 is a CT scan done at 1/16/2015, that shows (in my opinion): a soft tissue swelling (small one) behind the left ear (images 17-18), and an indentation only seen in the scout (initial localisation x-ray of the CT scan), because the sagital reconstruction of the bone window is not possible.

The fracture and indentation are easily visible at the CT scan done in 2016, because sagital reconstruction is possible in this CT scan.

in this CT scan the fracture seems to be not so recent.

Remainder: it is not possible to evaluate the exact time of a skull fracture with a CT scan.

As I mentioned before, these CT scan findings cannot substitute medical and/or forensics evaluation, but can help in understanding better your condition.

Hope I helped you.

Let me know if I can assist you further.

Greetings.


Above answer was peer-reviewed by : Dr. Sonia Raina
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Follow up: Dr. Erion Spaho (1 hour later)
Good day Dr Spaho

With regards "in this CT scan the fracture seems to be not so recent", the indentation was only noted after incident, XXXXXXX 2015.

How does one estimate the age i.e. recent, or years old from the scans?

xxxxx
Does "Since the fracture is evident on the CT scan done at 16-01-2015, it is obvious that it was caused before the CT was done and indentation is the result of it." imply the indentation and fracture are linked to the same event (the indentation was noted after the blow to the head)?

Is the fractured correctly classified as a "depressed skull fracture"?
doctor
Answered by Dr. Erion Spaho (12 hours later)
Brief Answer:
A partial depressed fracture.

Detailed Answer:
Hello again.

The indentation is actually a consequence of the fracture, yes the fracture is a depressed one, but only the outer part of the skull is involved, not the entire thickness of it.

It is necessary for a CT scan with thin bone cuts and 3D reconstruction in order to get a correct understanding of the fracture anatomy and to evaluate approximately the fracture age.

Greetings.
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Dr. Erion Spaho

Neurologist, Surgical

Practicing since :2004

Answered : 4432 Questions

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What does my CT scan report indicate?

Brief Answer: Your questions answered below. Detailed Answer: Hello xxxxx and thanks for asking me directly. The fracture appears to be present at the older CT too (16-01-2016). Since the fracture is evident on the CT scan done at 16-01-2016, it is obvious that it was caused before the CT was done and indentation is the result of it. Minor signs of subcutaneous tissue swelling are evident too. Hope this helps. Feel free to ask us if you have other questions. Greetings.