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What Does My CT Scan Test Report Indicate?

Posted on Mon, 1 Aug 2016

Question: Good day Dr XXXXXXX

a) Patient suffered one or more blows to the head 30 Jun, 2016. Upon visiting local doctor with headache, patient's pulse is recorded at between 93-97, 3 hours after the incident. A swelling is diagnosed on inspection on the left side approx 1" above the ear. A bearable pain noted when pressure applied to the swelling. CT scan is performed.

Are you able to detect and confirm the swelling in subcutaneous temporal region(s)?

b) There is a notable permanent indentation on the top center back of the patient's head which can be felt by touch and seen from a blow to the head approx. 1.5 years ago. Are you able to verify "indentation is visible at bone sagital window of the CT scan, more exactly images 26 and 27", and indentations "clearly visible in Series 80315 as well as 80317" from CT scan ID:0000 as fracture?

For CT images, please refer to: Google Drive link: https://drive.google.com/folderview?id=0B90glucIcidFdl12346Ua28&usp=sharing, including zip of DICOM set for ID:0000.

Answered by Dr. Praveen K Nath (9 hours later)

Brief Answer:
OLD/ NEW HEAD INJURY .

Detailed Answer:
Dear Mr Mark
Hello
My best wishes for complete recovery .

I have gone through all your detailed medical history and ct scan images in your link .

a. As per CT scan dated 2016.07.01 , there seems to be left temporal scalp swelling (small). it,s not so remarkable on right temporal region.

b. Yes Mr Mark , I could make out a small indentation on occipital part , better seen on series 80317. BUT whether this mark is secondary to an old healed fracture or it,s a natural anomaly of occipital bone , cannot be ascertained. As such anomalies are very common in occipital bone.

To ascertain if it,s an old healed fracture , you need to actually see a fresh fracture without callus formation in old CT scan at the same spot.

Hope this answers your querry .
I am sorry for delay in answering as i was busy with emergencies .

Feel free to ask any further querry

Thanks

Dr Praveen XXXXXXX Nath
Director
Deptt. of Neurosurgery

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Praveen K Nath (40 minutes later)

Good day Dr XXXXXXX

It is know that the indentation, easily noticed on sight and touch, appeared after the an incident 15 XXXXXXX 2015. A CT scan was taken 16 XXXXXXX 2015, available at https://drive.google.com/open?id=0B90glucIcidFeFdGV12345 as 0000-0000.zip.

Is it possible to confirm the link between the indentation, and the fracture from CT scan 0000-0000?

Please advise if a new thread / payment would need to be processed to complete the assessment of the 2 scans for same patient?

Answered by Dr. Praveen K Nath (15 hours later)

Brief Answer:
Head injury follow up

Detailed Answer:
Dear Mr Mark
Hello

ANY history of trauma over that area / clinical examination of patient / presence of scar or indentation in that area / fresh fracture line in that area , ALL these are confirmatory evidences of bony indentation as a sequelae of healed fractured bone .

I tried many times to open up CT scan images date 2015 01 16,but link is not working . You may sent these CT images in JPEG format .
You are always welcome to ask any further query.

Thanks

Dr Praveen K Nath
Director
Deptt. of neurosurgery

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Praveen K Nath (8 hours later)

Good day Dr XXXXXXX

66 images uploaded to same Google Drive folder: https://drive.google.com/open?id=0B901234dFeFdGVDBnWW5yQ0E. 0000-0000.png.zip is ZIP archive of the 66 images as a single download option.

Files in PNG image file format as captured from Syngo fastView.

Answered by Dr. Praveen K Nath (11 hours later)

Brief Answer:
head injury follow up

Detailed Answer:
Dear Mr Mark
Hello

I still feel sorry as i am unable to open this link and images (https://drive.google.com/open?id=0B90glucIcidFeFdGVDBnWW5yQ0E. 0000-0000.png.zip )

You can reload these images on g drive & send the link or you can send isolated images in JPEG format .

Hope it works .
Thanks

Dr Praveen k Nath
Director
Deptt. of neurosurgery

Above answer was peer-reviewed by : Dr. Veerisetty Shyamkumar

Follow up: Dr. Praveen K Nath (6 hours later)

Good day Dr XXXXXXX

Isolated images, and ZIP of the 66 images should be available at:
https://drive.google.com/folderview?id=0B90glucIcidFeFdGVDBn1234

Standard Windows Paint should be able to open PNG files.

Additional notes: Mark visits doctor days after the incident XXXXXXX 2015 and asks doctor about the bump on the top center back of the head. Doctor advises on soft tissue swelling and that it should go away over time. It did, leaving the noticeable indentation which matches that of the side of a pole, or broomstick. It's like that of a groove that the side of a finger slots into.

Answered by Dr. Praveen K Nath (14 hours later)

Brief Answer:
HEAD INJURY -FOLLOW UP

Detailed Answer:
Dear Mr Mark
Hello
I have seen all your CT head images .
There is NO obvious remarkable fracture seen on XXXXXXX 2015 scan .
ONLY DOUBTFUL area i could make out is in image number59 .0000-0000.png.zip. Possibility of a doubtful outer table fracture can not be ruled out in this image . Sagittal reconstruction image could have cleared this doubt .

SECONDLY groovy indentation felt on head can be due to a scalp scarring ,not necessarily due to depression in bone .

Hope this answers your querry

Thanks

Dr Praveen k Nath
Director
Deptt. of neurosurgery

Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Nagamani Ng