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A CT-Based Clinical Overview from Muhammad Abubakar: Stroke and Intracranial Hemorrhages
Muhammad Abubakar/LinkedIn
Dec 20, 2025, 18:19

A CT-Based Clinical Overview from Muhammad Abubakar: Stroke and Intracranial Hemorrhages

Muhammad Abubakar, Member of Congress of Neurological Surgeons (CNS), shared on LinkedIn:

”Stroke and Intracranial Hemorrhages — A CT-Based clinical Overview

Stroke is a radiological and clinical emergency.

Rapid CT interpretation can be lifesaving.

Here’s a structured breakdown every medical student and clinician should master:

STROKE — THE BIG PICTURE

Ischemic Stroke (≈85%)

Cause: Arterial occlusion → cerebral infarction

Early CT (may be normal):
• Loss of gray–white matter differentiation
• Insular ribbon sign
• Hyperdense MCA sign

Late CT:
• Hypodense wedge-shaped infarct
• Sulcal effacement
• Mass effect due to edema

Rule: Always exclude hemorrhage on CT before thrombolysis.

Hemorrhagic Stroke (≈15%)

Cause: Vessel rupture → bleeding
CT hallmark:
• Hyperdense (white) blood

EXTRA-AXIAL HEMORRHAGES

Epidural Hemorrhage (EDH)

Cause: Middle meningeal artery injury (trauma)

CT Findings:

  • Biconvex / lentiform shape
  • Does not cross suture lines
  • Classically associated with lucid interval

Subdural Hemorrhage (SDH)

Cause: Bridging vein tear
CT Findings:

  • Crescent-shaped collection
  • Crosses suture lines (not midline)

Acute → white – hyperdense
Chronic → black – hypodense

Subarachnoid Hemorrhage (SAH)

Cause: Berry aneurysm rupture / trauma
CT Findings:

  • Hyperdensity in sulci, cisterns, fissures
  • “Star-shaped” basal cisterns
  • Sudden worst headache of life

INTRA-AXIAL HEMORRHAGES

Intracerebral / Intraparenchymal Hemorrhage (ICH)

Cause: Hypertension, cerebral amyloid angiopathy
CT Findings:

  • Localized hyperdense bleed within brain parenchyma
  • Surrounding hypodense edema
  • Common sites: basal ganglia, thalamus, pons, cerebellum

Intraventricular Hemorrhage (IVH)

Cause: Extension of ICH / neonatal germinal matrix bleed
CT Findings:

  • Hyperdense blood layering in ventricles
  • Ventricular dilatation → hydrocephalus

ONE-LINE MEMORY AID

CT Rules to Remember:
Blood = White
Ischemia = Dark (late)
Extra-axial → shape matters
Intra-axial → location matters

Mastering CT patterns equals faster diagnosis plus better neurological outcomes”

A CT-Based Clinical Overview from Muhammad Abubakar: Stroke and Intracranial Hemorrhages

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