Radiological features of Raised ICP on CT Brain (in a nutshell)
🧠 Key CT Findings
1. Sulcal effacement
- Loss/obliteration of cortical sulci
- Earliest sign of diffuse cerebral edema
2. Ventricular compression
- Slit-like or reduced size of lateral and third ventricles
- May progress to near-complete effacement
3. Basal cistern effacement
- Obliteration of:
- Suprasellar cistern
- Perimesencephalic cistern
- Ambient cistern
- Strong indicator of significant ICP rise
- Suprasellar cistern
- Perimesencephalic cistern
- Ambient cistern
4. Midline shift
- Displacement of septum pellucidum
- Indicates mass effect (quantify in mm)
5. Diffuse cerebral edema
- Loss of gray–white matter differentiation
- Generalized hypodensity of brain parenchyma
6. Herniation signs
- Subfalcine → cingulate gyrus shift under falx
- Uncal (transtentorial) → medial temporal lobe displacement
- Tonsillar → cerebellar tonsils descending (better on MRI but indirect CT signs present)
7. Effacement of CSF spaces
- Narrowing/obliteration of:
- Cortical sulci
- Ventricles
- Cisterns
- Cortical sulci
- Ventricles
- Cisterns
🔑 Compact Mnemonic
“SVeB MeD Her”
- Sulci effaced
- Ventricles compressed
- Basal cisterns obliterated
- Midline shift
- Diffuse edema (↓ G-W differentiation)
- Herniation signs


