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REVIEW  INTEGRATED RX-ECO-TC IMAGING IN INTENSIVE CARE 

Il Giornale Italiano di Radiologia Medica 2018 Maggio-Giugno;5(3):408-19

DOI: 10.23736/S2283-8376.18.00071-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Integrated imaging in postneurosurgical intensive therapy

Chiara ANDREOLI 1, Ginevra DANTI 2 , Diletta COZZI 2, Maria L. DE CICCO 1, Claudio DI BIASI 1, Gianfranco GUALDI 1

1 UOSD Diagnostica per Immagini in Emergenza Urgenza, Azienda Policlinico Umberto I, Roma, Italia; 2 SOD Radiodiagnostica di Emergenza Urgenza, Azienda Ospedaliero Universitaria Careggi, Firenze, Italia


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Imaging plays an essential role in evaluating patients in neurosurgical intensive care and allows to quickly recognize any complication and to guide the treatment. In order to know the complications, it is essential to understand the normal post-surgical changes that alter the skull anatomy, also depending on the type of surgery that is performed (burr hole, craniotomy, craniectomy, cranioplasty). Just knowing how anatomy changes after surgery, we will be able to recognize early complications (tensive pneumocephalus, hemorrhage, ischemia, abscess, empiema, cerebral edema), some of which extremely serious and susceptible to a re-intervention in emergency. Computed tomography (CT) is the main imaging modality used in the immediate post-operative time, because is fast (considering that often the patient is not collaborative) and highly sensitive in detecting the main complications. Magnetic resonance imaging (MRI), however, is performed in the following days as it has increased sensitivity in detecting post-operative infections and arterial and venous ischemic complications, thanks also to the diffusion sequence (DWI), which is extremely reliable to detect infections and ischemia.


KEY WORDS: Central nervous system - Tomography, X-ray computed - Magnetic resonance imaging - Intensive care units

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