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CLASP Radiology > Brain Imaging > Flashcards

Brain Imaging Flashcards

1
Q

What is first line investigation for brain?

A

CT with or without IV contrast

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2
Q

Which type of imaging is best for soft tissue resolution and shows grey white matter definition?

A

MRI

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3
Q

What are downsides of MRI? (3)

A

Long scan
Contra-indicated for some e.g. pacemakers
not suitable for acutely unwell patients

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4
Q

What cistern is the circle of Willis in?

A

Supracellar cistern

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5
Q

What colour is fluid in T1 and T2 weighted MRIs?

A

T1- black fluid

T2 - white fluid

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6
Q

What are 2 types of intracranial haemorrhage & 3 types of second one?

A

Intra-axial - within brain substance
Extra-axial - out with brain parenchyma but inside the skull
- extra dural, SU dural, subarachnoid

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7
Q

What is typical appearance of hypertensive bleed?

A

Acute haematoma in the right basal ganglia (thalamus)

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8
Q

What is most common cause of extradural haemorrhage?

A

Trauma, especially skull fracture

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9
Q

What haematoma is lentiform (biconvex) shaped?

A

Extramural haematoma

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10
Q

In terms of age groups (Elderly, young and infants) what are the most common causes of subdural haemorrhages in each group?

A

Elderly - falls
Young - RTA
Infants - NAI e.g. shaken baby syndrome

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11
Q

What is classic shape of subdural haematoma?

A

Semilunar shape

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12
Q

Subdural haematomas do not cross the sutures. True/false?

A

False - they do cross sutures

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13
Q

How do subacute haemorrhages present on imaging?

And how do chronic haemorrhages present on imaging?

A

Subacute - isodense - mixed attenuation (blood is mixed)

Chronic - hypodense - low attenuation

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14
Q

WHere is subarachnoid most commonly

A

85% berry aneurysm
Arising in circle of Willis
Can be traumatic/vascular malformations

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15
Q

How do subarachnoid haemorrhages present on brain imaging?

A

Hyper dense material seen in subarachnoid space

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16
Q

What is the next step after CT when subarachnoid blood is found in the absence of appropriate history of trauma?

A

CT cerebral angiogram for berry aneurysm

17
Q

What are 3 complications of subarachnoid blood being in brain?

A

hydrocephalus, vasospasm and infarction

18
Q

What is the most common type of brain tumour in adults and kids?

A

Adults - metastasis

Kids - primary brain tumours

19
Q

Metastasis tend to be very irritant and cause a lot of oedema and mass effect & tend to be rounded lesion with hyper dense outer and hypodense . True/false?

A

True

20
Q

Metastasis tend to pick up IV contrast well. True/false?

A

True

21
Q

What 3 imaging factors change depend on grade of tumour?

A

Degree of oedema
Mass effect
Enhancement

22
Q

What is coning and why is it fatal if not corrected?

A

Cerebellar tonsillar herniation below the foramen magnum

Fatal because brainstem compressed against Clivus which affects cardiac and respiratory centres of pons and medulla

23
Q

What is name of bag of spinal cord

A

Thecal sac

24
Q

From where in brain does spinal cord extend from

A

Corticomedullary junction

25
Q

What are hallmarks of stroke?

A

Wedge shaped
Cortical loss
Lose normal grey & white matter differentiation
Reduced attenuation
Brain starts to become swollen - can’t see sulci so well

26
Q

What occurs after stroke and how does it appear on imaging?

A

Gliosis - appears as region of low density with volume loss

27
Q

What is first line imaging in case of spinal cord compression?

A

MRI

28
Q

Why isn’t CT sufficient for Spinal cord compression imaging?

A

CT can show vertebral fracutre etc but won’t show spinal cord deviation/compression

29
Q

What factors contribute to likelihood of transformation of haemorrhagic infarct?

A

Size of infarct

Window of stroke

30
Q

What is main form of investigation in subdural haemorrhage?

A

CT scan

CLASP Radiology (4 decks)

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