 Good morning all myself Dr. Kalyani, second year postgraduate in department of radio diagnosis, Jim's Srikakulam. Today I'm going to present my paper on role of CT in traumatic head injury. My aim in present study was to evaluate and assess the CT in patient with head trauma and to study the various cranio cerebral changes that occur in the trauma to head in the CT. Head injury is a trauma resulting injury to the scalp, skull or brain. Head injuries due to road traffic accidents have become a daily occurrence and increased toll on human lives and limbs. Most of these patients are in the prime in the third and fourth decade of their life, and they have direct social socioeconomic impact beside the emotional burden of suffering, a lifelong debilitating loss of function. Immediate and instantaneous death following cranial trauma occurs due to unpreventable primary brain injuries. However, death occurring within 24 hours of cranial cerebral trauma can be avoided by timely institution of diagnostic and therapeutic measures that could prevent secondary brain incels. Previously, the mainstream diagnosis of trauma traumatic lesions was best clinically evaluated and in plain row angiograms of skull and cerebral angiography and accurate diagnosis cannot be made on the basis of physical examination, except on rare occasion in addition that extremely deteriorating condition it is difficult to perform a detailed examination. Sir Godfrey House will describe CT 1973 and prompt recognition of injuries and critical to reduce mortality and CT head is the cornerstone for diagnosis. The follow up assessment using CT is frequently necessary to detect progression and stability of lesions and evidence of the layer complications and sequelae of cerebral injuries, which can determine whether surgical intervention is needed, whether intubation is needed or not, and CT is the single diagnostic modality in the evaluation of a patient with a head injury. Besides rapid implementation it can demonstrate a significant primary traumatic injuries including EDH, SDH, intracerebral hematomas, SAH, intramural hemorrhages, skull fractures, cerebral edema and etc. Due to refined technology can further help in diagnosing diffuse axonal injuries which were never thought of, CT is widely available rapidly permits a diagnosis and monitoring of unstable patients. Moreover, CT aid in surgical planning, prognosticating outcome and recovery time. This study attempts to assess the utility of CT in the diagnosis, management and prognosis of patient with cerebral trauma and my objectives are to evaluate the role of CT in a patient with head trauma to describe various spectrum of hemorrhages. Those occur in head trauma with aid of CT and to evaluate the early CT imaging with GCS and the patient prognosis. I have done prospective study, conducted prospective study for the period of one year and it is comprised of all the head trauma patient coming to the emergency patient about 80 patients I've taken and evaluated by CT scan of head using 16 slice CT machine in gems. My inclusion criteria are all age groups with head trauma, head trauma that has occurred, but within 24 hours patient with head trauma treated as in in patients and I have excluded or cranial trauma during childbirth, non-traumatic intracranial breeds patient on anti-cogulants, hypertensive, non-hypertensives, previous CVS, CVS patient with non-bleeding disorders. I have taken a complete history of the patient in a preforma, which included AIDS, sex, type of injury, the type was further classified into road traffic accidents, falls, assaults, industrial accidents and miscellaneous follow up a follow up a follow up a patient in the hospital stay was performed and after initial assertion severity of tenor cerebral injury was graded with the help of GCS. CT protocol were examined with CT scanners in the sleep supine position proper immobilization was attained proper head position was attained then a wide window setting was studied to visualize the various cerebral changes. And I've got the results like a total of 80 patients who sustained head injury, presenting to emergency were analyzed 58, 58 patients that is approximately 72.5% per male and 22 that is 27.5% per female that is my, my studies made is to female ratio was 2.6 to 1 ages range from one year to 70 years the highest frequency of head trauma occurred as I discussed the 31 to 50 years like third and fourth decade of the life and the most common cause of hand injury RTA that is approximately 65%. And this is the table showing patients with head trauma presenting with various symptoms maximum of the patient that is 46% patients present with loss of consciousness, then vomiting about 35% followed by seizures alcohol consumption black eyes and CSF range is the least. And this is the table showing severity of head injury based on mode of head injury, like out of 85 sustained mild head injury, 12% cases as a moderate head injury and 13 had severe head injury, and RTA was a prime and the major ideological factor in all types of severity of head injuries. And this is the graph showing various lesions with patients with craniocellular trauma, like 25 patients that is 31.2% had normal CT findings, 68.8% that's 55 patients had abnormal CT in which 48.8% fracture followed by EDH contusions and leads to the intravendical hemorrhage. And this is another table showing linear skull fracture was predominant seen in 30% of cases, followed by basilar community and depressed and diastatic fracture was the least abnormal CT findings were seen in 54.5% patients sustained mild mild head injury in all patients with moderate and severe head injuries. And the p value is 0.01 which was statistically significant. Then comes to discussion heading to the increasing health program globally it is the leading cause of death and disability in children, adults and the major product and the in the most productive age and the patient with a head injury will be very useful in the management of the patient. The first study the age of the patient varies from one year to seven years majority of the patient found to be in the third and fourth decade of the life. The group is this group this age group is the most active groups, as we know they'll go out for the work and they'll do the basic living and time, the males are more prone to the cranial cerebral trauma as, as most of them males to go out for to earn their livelihood, and that's where the our male is to female issues to 1.6 to 1, which was observed, which is similar with the study conducted in the USA with an instance ratio greater than 2 to 1 for males compared to females. The reason for male predominance is that males, as we discussed males more for their livelihood. Okay, then, then traumatic brain injury is a prevalent and potentially devastating problem because from proper management can significantly alter their course, especially within 48 hours of injury, neuroimaging techniques which can be determined which can determine the presence and extent of the injury and guide surgical planning and minimally invasive interventions play important roles in the acute therapy of traumatic brain injury. Besides facilitating rapid, rapid implementation, it can demonstrate some primary traumatic injuries, like EDH, SDH, IVH, etc. The present day scanners can even as we already discussed it can, it can diagnose diffuse axonal injuries, which were never thought of, and CT is currently a procedure of choice over MRI because it's faster and more readily available. So it is cost effective non-invasive and assess the, and non-invasive method to assess the time and extent of cerebral injury. This study attempts to determine the utility of CT, CT in the diagnosis management and prognosis of patient with cerebral trauma. These are some of the images which are showing fracture line in the right zygomatic arch and lateral wall of right orbit and fracture line in the middle and lateral wall of orbit and next shows the linear displace fracture not in the anterior wall of the left max sinus. Then these are the images showing some hemorrhages. My conclusion is CT is the most comprehensive diagnostic modality for accurate localization of the site of injury in TBI. The early and timely diagnosis of the precise lesion by CT not only had the substantial impact over instituting appropriate treatment and timely surgical intervention but also helped in predicting the ultimate outcome. These are my references. Thank you.