4. Metabolic and Toxic Flashcards
Alochol = low sodium = radpid correction of hypnatremioa = Pseudobulbar palsy (slurred speech, sensitive gag reflex, labile emotional response = coma = death =
Osmotic Demyelination or
Central Pontine Myeilnolysis
Osmotic Demyelination or
Central Pontine Myeilnolysis
Bright T2 changes - central pons
Restricted diffusion in lower pons
+ extra-pontine presentation
Thiamine (vitamine B1) deficiency = 1. Acute confution 2. Ataxia 3. Ophthalmoplegia = Chronic Memory loss and confabulation(Korsakoff psychosis) = death
Wernicke Encephalopathy
Wernicke Encephalopathy
T2/Flar bright changes - medial/dorsal thalamus (around 3rd ventrilce) periaqued
with enhancemnet in the mamillary bodies
Lacttate onf MRS
Tx: Thiamine replacement
Seizure + Muscle rigidity + impaired coordination + Mental confusion + Altered gait =
Marchiafava-Bignami
Marchiafava-Bignami
Hight T2/Flair in corpus callosum
Classic findings of Direct alcohol injury
Atrophy - Cerebellum and specially the VERMIS
Copper and MAnganese Deposition
T1 Bright - basal ganglia
CArbon monoxide vs Methanol
Carbon monoxide
CT: hypodense
MRI: T2 bright
Location: globus pallidus
(carbon monoxide causes “globus ” warming)
Methanol
MRI: T2 Bright
Location: Putamen
PRES [Posterior Reversible Enceptiaiopathy Syndrome]
Asymmetric cortical and subcortical white matter edema
NO restricted diffusion - not a stroke
Hx of Acute HTN or Chemotherapy
Post Radiation changes
1-6 months - Early delated
High T2/FLAIR in the periventricular white matter - reverisbile
6months - LAte delated
Mosaic pattern with hight WM signal changes - mass like, expansile -reversible
LONGE term sequela
1. Radiation induced vasculopathy - Strokes and Moya-moya tpye of look
- Mineralizing Microangiopathy - calcifications in basal ganglia and subcortical white matter
- Vascular malformation - capillary telangiectasia/cavernous malformation
Blooming artifacts
- Radiation induced cancer - Meningioma 15 years post XRT - MOST COMMON
