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Y3 - CLASP anatomy and radiology > Brain > Flashcards

Brain Flashcards

1
Q

benefits of CT

A

fast
well tolerated
can use contrast
interventions such as angiography, venography

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2
Q

benefits of MRI

A

better soft tissue resolution
can use contrast
specialist imvx

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3
Q

drawbacks of MRI

A

longer duration
contra-indicated for some
can be poorly tolerated

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4
Q

are brain X-rays used

A

not really

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5
Q

what causes an ischaemic stroke?

A

a sudden cessation of adequate amounts of blood reaching parts of the brain.

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6
Q

what is the typical presentation of an ischaemic stroke?

A

rapid onset neurological deficit, which is determined by the area of the brain that is involved

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7
Q

pathophysiology of stroke

A

Interruption of blood flow through an intracranial artery leads to deprivation of oxygen and glucose -> if circulation is not re-established -> liquefactive necrosis

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8
Q

T2 weighted image

A

fluid will be bright

better for pathology

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9
Q

T1 weighted image

A

fluid will be black

better for anatomy

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10
Q

why image in stroke?

A

exclude intracranial haemorrhage
confirm ischaemia
exclude other pathologies that may mimic stroke eg tumour
permit rapid treatment

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11
Q

gold standard scan in stroke

A

non contrast CT scan

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12
Q

3 categories of cause of stroke

A

embolis
thrombosis
arterial dissection

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13
Q

earliest CT signs of stroke

A

hyperdense segment of a vessel

direct visualisation of the intravascular thrombus/embolus

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14
Q

within a few hours of stroke CT

A

loss of grey-white matter differentiation
hypoattenuation of deep nuclei: cortical hypodensity with associated parenchymal swelling with resultant gyral effacement

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15
Q

after significant time of stroke on CT

A

significant mass effect

gliosis

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16
Q

intracranial haemorrhage causes

A

traumatic
atraumatic
due to an underlying lesion

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17
Q

what colour is acute blood on an unenhanced scan

A

white

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18
Q

types of intracranial haemorrhage

A

intra axial

extra axial

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19
Q

intra axial intra cranial haemorrhage

A

within the brain substance

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20
Q

extra axial intracranial haemorrhage

A

outwith the brain parenchyma but in side the skull

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21
Q

what are extra axial intracranial haemorrhage divided into

A

extra dural
subdural
subarachnoid

22
Q

what is an extradural haemorrhage

A

Collection of blood between the inner surface of the skull and outer layer of the dura, .

23
Q

extradural haemorrhages are not usually assoc with trauma

A

false, usually assoc with trauma esp skull fracture

24
Q

most common vessel bleeding in extra dural haemorrhage

A

middle meningeal artery

25
Q

what shape are extra dural haemorrhages

A

biconvex

26
Q

complication of extradural haemorrhage

A

mass effect with herniation

27
Q

what is subdural haemorrhage?

A

Collection of blood accumulating in the subdural space, the potential space between the dura and arachnoid mater

28
Q

main cause of subdural haemorrhage

A

head trauma

29
Q

causes of subdural haemorrhage by age group

A

infants- NAI
young adults - RTA
elderly - falls

30
Q

shape of subdural haemorrhage

A

Semilunar shape

Crosses the sutures

31
Q

describe subarachnoid haemorrhage

A

Extra-axial intracranial haemorrhage

Blood within the subarachnoid space

32
Q

appearance of subarachnoid haemorrhage

A

Hyperdense material is seen filling the subarachnoid space.

33
Q

most common location of subarachnoid haemorrhage

A

circle of willis (berry aneurysm)

34
Q

causes of subarachnoid haemorrhage

A

traumatic

vascular malformations

35
Q

subarachnoid haemorrhage on scan

A

Large volume of HIGH ATTENUATION acute blood in the

  1. Suprasellar cistern
  2. Sylvian fissures
  3. Sulci
36
Q

if SAH occurs in the absence of trauma, what is performed to look for berry aneurysm

A

CT cerebral angiography

37
Q

complications of SAH

A

HYDOCEPHALUS
VASOSPASM
INFARCTION

38
Q

where does metastasis to the brain most commonly come from

A 
lung 
breast
melanoma 
renal cell 
colorectal
39
Q

appearance of intracranial mass on CT

A

hypo- or hyper dense
often rounded
solitary or multiple

40
Q

use of CT for masses

A

useful to determine oedema/mass effect

41
Q

metastasis to the brain appearance

A

usually multiple masses
oedema
mass effect
avidly enhance

42
Q

primary brain tumours appearance

A

usually solitary mass

degree of effect depends on grade of tumour

43
Q

describe mass effect and brain herniation

A

Shift of cerebral tissue from its normal location, into an adjacent space as a result of mass effect

44
Q

describe tonsilar herniation

A

Descent of the cerebellar tonsils below the foramen magnum

45
Q

what is tonsilar herniation called clinically

A

coning

46
Q

result of tonsilar herniation

A

Brainstem is compressed against the clivus altering the vital life-sustaining functions of the pons and medulla (eg respiratory and cardiac centres)
Fatal if not corrected

47
Q

describe hydrocephalus

A

The flow of CSF becomes impaired either due to anatomical obstruction of normal reservoirs/channels or because it can no longer be resorbed
The upstream CSF spaces become dilated and CSF leaks out across the barriers

48
Q

treatment of spinal cord compression

A

prompt surgical decompression

49
Q

causes of spinal cord compression

A 
disc issues 
vertebral trauma or tumour 
epidural abscess or haematoma 
spinal meningioma 
nerve sheet tumour in the intradural space
50
Q

presentation of spinal cord compression

A

back pain with red flags

51
Q

red flags back pain

A 
history of malignancy
Major trauma
Thoracic/radicular pain
constant, progressive, non- mechanical pain
systemically unwell
widespread neurological signs and symptoms 
Loss of power in lower limbs
loss of sensation, saddle anaesthesia 
urinary retention
52
Q

invx spinal cord compression

A

MRI spine as you can’t see the spinal cord or conus medullaris in CT or X-ray

Y3 - CLASP anatomy and radiology (4 decks)

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