Computed tomography (CT) has become the primary diagnostic tool for the evaluation of complex injuries of trauma patients and is often used as part of the triage. The advancing speed, spatial resolution and the multi-energy scanning allowing for a more precise and dicisive diagnosis of injuries in multiple organ regions utilizing the initial full-body CT. It is appears to be imporatn to remember that there are basic limitations that are - although altered with progressing scanner technology - not eliminated and that lead to artifacts...

Traumatic brain injury (TBI) is a leading cause of death and disability. 2.8 million TBI related emergency department visits and hospitalization were registered in 2013 in the USA. TBI contributed to the death of almost 50,000 people and was a leading cause of long-term disability. Main causes for TBI were falls (47%), struck by an object (15%) and motor vehicle accidents (14%). The percentage of fall related TBI varies between the age groups from 0-14-year-old children (54%) and adults >65 years (79%). Most TBI related...

The most important artifacts in traumatic Head CT are depending on the close proximity of the epi- and subdural space to the high attenuating skull and can be generally divided in the following categories: 1) Beam hardening of a poly-chromatic x-ray beam: This effect occurs whenever the x-ray beam comprised of multiple energies is penetrating an object, leading to selective attenuation of lower energy photons (Fig.2a). The effect is most prominent in high density structures like the skull. The higher energy photons are passing through...

Summary: The detection of intra-cranial hemorrhages has an immediate impact on the treatment, hospitalization and potential long-term outcome of TBI patients. Thin slice 190 keV virtual monochromatic images are helpful to reduce beam hardening and partial volume artifacts artifacts - improving the detection of epi- and subdural hemorrhages close to osseous structures of the skull. These images are not suitable to solely replace conventional brain CT images – but are improving the detection of these hemorrhages . A DECT trauma head CT consists therefore ideally...

1. 1.Centers for Disease Control and Prevention (CDC): Traumatic Brain injury & concussion, 2017 2. 2.Bodanapally UK, Shanmuganathan K, Issa G, Dreizin D, Li G, Sudini K, Fleiter TR. Dual Energy CT in Enhancing Subdural Effusions that Masquerade as Subdural Hematomas: Diagnosis with Virtual High-Monochromatic (190keV) images. AJNR AM J Neuroradiol. 2017; 38(10):1946-1952 3. 3.Bodanapally UK et al. Dual-Energy CT in Hemorrhagic Progression of Cerebral Contusion: Overestimation of Hematoma Volumes on Standard 120-kV Images and Rectification with Virtual High-Energy Monochromatic Images after Contrast-Enhanced Whole-Body Imaging....