Computed Tomography (CT) Scanning Categories of Marshall et al for a Patient with Traumatic Head Injury

Description

Marshall et al described changes in the head CT scan associated with head trauma. This can help improve communication of findings between clinicians. The authors are from the University of California at San Diego, University of Texas at Galveston, University of Virginia, Indiana University and the National Institute of Neurological Disorders at NIH.

Parameters:

(1) cisterns

(2) midline shift in mm

(3) densities present OR bone fragments OR foreign bodies

(4) mixed or high-density lesions > 25 mL in volume

Cisterns	Midline Shift	Any Densities	Density > 25 mL	Diffuse Category
normal	0 mm	absent	none	I
normal	0 to 5 mm	variable	none	II
compressed or absent	0 to 5 mm	variable	none	III
compressed or absent	> 5 mm	variable	none	IV

The presence of a mixed or high-density lesion > 25 mL indicates a mass lesion. A mass lesion is classified as:

(1) evacuated (surgically removed), applied to any size (CT classV)

(2) nonevacuated (CT class VI)

where:

• Diffuse Category III indicates swelling.

• Diffuse Category IV indicates shift.

• Multiple small densities could have a total volume > 25 mL.

• A spherical lesion with a volume of 25 mL has a diameter of 18.4 mm.

• In Table 1 (page S15) it defines an evacuated mass lesion as any lesion surgically removed with no mention of size. However, the use of diffuse injury being defined as no density > 25 mL indicates that this is the cutoff for a mass lesion.

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Description

Specialty

ICD-10