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CLASP Radiology > Brain > Flashcards

Brain Flashcards

1
Q

what do you call the gyri in the cerebellum

A

folia

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2
Q

what imaging modality is best for seeing pathology

A

T2

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3
Q

what is impacted in a posterior circulation stroke

A

occipital lobes

vision problems, vertigo

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4
Q

what determines the neurological defect a patient presents with in stroke

A

anatomical site of injury to brain parenchyma

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5
Q

what do you need to confirm the absence of to start thrombolysis/thromboectomy

A 
haemorrhage (do unenhanced CT to look for blood) 
stroke mimic (tumour, seizure etc)
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6
Q

what is the PCA territory

A

occipital lobes

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7
Q

what is MCA territory

A

outside of brain

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8
Q

what is ACA territory

A

inside of brain up to frontal lobes

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9
Q

earliest visible CT sign for ismchaemic stroke

A

hyperdense segment of a vessel

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10
Q

wishing first few hours what does ismchaemic stroke look like on CT

A

loss of grey-white matter differentiation
hypo attenuation of deep nuclei (happens in insular cortex first?)

cortical hypo density with associated parenchymal swelling with resultant gyral enhancement

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11
Q

what does advanced stroke look like on CT

A

hypo attenuation and swelling become more marked resulting in significant mass effect

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12
Q

what does advanced ismchaemic stroke look like on CT

A

hypo attenuation and swelling become more marked resulting in significant mass effect

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13
Q

what does an old ischaemic stroke look like on CT

A

more gloss occurs eventually appearing as region of low density with volume loss

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14
Q

what does acute blood appear as on unenhanced CT

A

white

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15
Q

causes of intracranial haemorrhage

A

trauma

underlying lesion

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16
Q

what is intra axial haemorrhage

A

within the brain substance

17
Q

example of axial haemorrhage

A

lobar haemorrhage
midline shift

acute haematoma in basal ganglia (type of haemorrhage stroke)

18
Q

what is extra-axial haemorrhage

A

out with the brain substance

eg. in the meninges

19
Q

what is extradural haemorrhage

A

between the skull and the outer layer of dura

usually associated with trauma

bleeding usually arterial most common from torn middle meningeal

classically overlies the temporal parietal region

mass effect causing midline shift

20
Q

what is a subdural haemorrhage

A

blood between dura and arachnoid matter

normally in elderly patients due to tearing of bridging veins as brain shrinks away from dura with age

also seen in shaken baby syndrome

needs CT

semilunar shape

crosses structures

mass effect

subdural will NOT cross the midline

if you can’t see sulci going all the way out to the edge its a sign of subdural haematoma (chronic)

moon shaped

21
Q

what does an acute on chronic subdural haematoma look like

A

chronic clotted blood goes to back, new acute blood goes to front

22
Q

what is subarachnoid haemorrhage

A

blood within the subarachnoid space

hyper dense material found filling the subarachnoid space

commonly around the circle of willis

can be traumatic or located to other vascular formations

WHITE STAR SIGN

see it in:

  • suprasellar cistern
  • others

do CT cerebral angiography to look for underlying berry aneurysm

23
Q

what causes death in subarachnoid haemorrhage

A

hydrocephalus, vasospasm and infarction

24
Q

early signs of hydrocephalus

A

enlarged temporal horns

25
Q

most common causes of brain mets

A 
lung 
breast 
melanoma 
small cell 
colorectal
26
Q

first line test for brain mass

A

CT

can be hypo or hyper dense
solitary or multiple
useful to determine oedema/mass effect

if crossed BBB then will be enhanced?? less likely to if not??

27
Q

hallmarks of metastatic disease

A

lots of oedema
lots of mass effect
avidly enhance

28
Q

hallmarks of primary brain tumours

A

solitary
supra or infra tentorial
degree of oedema
mass effect and enhancement depends on grade

29
Q

most common brain tumour

A

glioma

30
Q

what is coning

A

basilar tonsils pushed out the bottom of the brain

31
Q

what is the spinal cord contained in

A

thecal sac

32
Q

what nerve root comes out the bottom of L3 for example:

A

L3

L4 comes out on top?

33
Q

causes of spinal cord compression

A 
disc 
vertebrae 
epidural space 
dura
intradural space
34
Q

treatment for cord compression

A

urgent MRI spine

35
Q

how does cord compression present

A

back pain with red flags

  • history of malignancy
  • major trauma
  • thoraci/radicular pain
  • constant progressive non-mechanical pain
  • systemically unwell
  • widespread neurological signs and symptoms

loss of power in lower limbs
saddle anaesthesia, loss of sensation

36
Q

treatment for cord compression

A

urgent MRI spine

treat cause?

CLASP Radiology (3 decks)

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