Radiology Terms in Plain Language: A Glossary for Patients and Families

Doctors use specific words in CT reports after a brain bleed. A glossary explains these terms in everyday language. It does not replace a conversation with the medical team or offer a personal diagnosis. Families often see reports that mention hyperdensity or hematoma volume and want clear meanings.

Patients and students benefit from knowing how these words connect to the ABC2-SPH score. This score estimates 30-day mortality risk after spontaneous intracerebral hemorrhage using five factors: patient age, Glasgow Coma Scale, hematoma volume calculated by the ABC/2 method, presence of intraventricular extension, and whether the bleed is in a deep or lobar location. Decisions about care always rest with the treating team.

What Hyperdensity Means on a CT Scan

Hyperdensity appears as a bright white area on the CT image. It shows material denser than the surrounding brain tissue. Fresh blood often measures between 40 and 90 Hounsfield units and looks hyperdense.

This finding matters because it marks the location of the bleed. Larger areas of hyperdensity usually indicate bigger hematoma volumes. The ABC/2 method uses these measurements to estimate volume in millilitres for the mortality score.

Hematoma and How Doctors Measure It

A hematoma is a collection of blood that has clotted inside brain tissue. On CT it looks like a white or grey mass. Volume is calculated by the ABC/2 formula: multiply the longest diameter, the perpendicular diameter, and the height in slices, then divide by two.

Hematoma size directly affects the ABC2-SPH score. Volumes above 30 millilitres raise the predicted 30-day mortality risk. The treating team reviews exact numbers before any plan is made.

Edema Surrounding the Bleed

Edema is swelling caused by fluid leaking into brain tissue around the hematoma. It appears darker than normal brain on CT. The swelling can increase pressure inside the skull.

Doctors watch edema because it contributes to mass effect. When edema grows, it can worsen midline shift and lower the Glasgow Coma Scale score. These changes feed into the overall ABC2-SPH mortality estimate.

Midline Shift and Brain Displacement

Midline shift occurs when the hematoma or edema pushes brain structures away from the center line. Radiologists measure the displacement in millimetres on axial slices. A shift greater than five millimetres often signals serious pressure.

This measurement matters for prognosis. Significant midline shift can reduce the Glasgow Coma Scale and raise the ABC2-SPH score. The team monitors serial scans to track any increase.

Mass Effect in Simple Terms

Mass effect describes any pressure a hematoma, edema, or both place on nearby brain tissue. It may compress ventricles or distort normal anatomy. CT reports often list the degree of mass effect, which influences the level of consciousness and therefore the Glasgow Coma Scale component of the score.

Intraventricular Extension of Blood

Intraventricular extension means blood has entered the fluid-filled chambers inside the brain. It appears as hyperdensity inside the ventricles on CT. This finding is one of the five variables in the ABC2-SPH score.

The presence of intraventricular blood worsens the mortality estimate. It can block normal fluid flow and lead to hydrocephalus. The score assigns extra points when this extension is seen.

Hydrocephalus and Blocked Fluid Flow

Hydrocephalus is enlargement of the ventricles caused by blocked cerebrospinal fluid. On CT the ventricles look bigger than normal. It often follows intraventricular extension after hemorrhage.

This complication can lower the Glasgow Coma Scale and raise intracranial pressure. The clinical team decides on any intervention.

Attenuation and Hounsfield Units

Attenuation refers to how much the X-ray beam is weakened by different tissues. Hounsfield units quantify this on a scale where water is zero, air is minus one thousand, and bone is over one thousand. Blood usually falls between 40 and 90 Hounsfield units.

Radiologists use these numbers to confirm that a hyperdensity is blood rather than calcium or contrast. Accurate identification of hematoma density helps the ABC/2 volume calculation that feeds the ABC2-SPH score.

Glasgow Coma Scale at the Bedside

The Glasgow Coma Scale is a quick neurological exam that scores eye opening, verbal response, and motor response. Total scores range from 3 to 15. Lower scores indicate worse consciousness.

This score forms a major part of the ABC2-SPH mortality estimate. A value below 9 adds significant points to the final risk. The treating team repeats the assessment regularly.

Lobar Versus Deep Bleed Location

Lobar location means the hematoma sits in the outer parts of the cerebral hemispheres. Deep location refers to bleeds in central structures such as the basal ganglia or thalamus. The ABC2-SPH score treats these locations differently.

Deep bleeds often carry higher mortality risk in the model. Location also guides possible causes and future imaging choices. The radiology report always states the site clearly.

• Hyperdensity shows fresh blood on CT.
• Hematoma volume is measured in millilitres with the ABC/2 method.
• Edema appears as darker areas around the bleed.
• Midline shift is measured in millimetres.
• Intraventricular extension adds points to the ABC2-SPH score.
• Glasgow Coma Scale ranges from 3 to 15.

The glossary above translates common terms found in CT reports after intracerebral hemorrhage. It pairs each term with a short everyday explanation and a note on its relevance to the scan. Remember this resource explains language only. A patient’s individual ABC2-SPH score and care plan are determined solely by the treating medical team after full review of history, labs, and serial imaging.