Brain imaging

Question 1

what imaging is indicated for Simple nasal bone fractures without significant deformity?

Answer 1

none

Question 2

when is an orbital xray indicated?

Answer 2

MRI screening for suspected metal

Question 3

preferred test for orbital fractures?

Answer 3

facial CT w/o contrast

Question 4

preferred test for orbital cellulitis

Answer 4

facial bones CT w/ contrast

Question 5

preferred test for retro-orbital hematoma

Answer 5

orbital CT w/ contrast

Question 6

preferred test for facial cellulitis

Answer 6

facial bones CT w/ contrast

Question 7

imaging for suspected cranial hemorrhages

Answer 7

head CT w/o contrast

Question 8

when is head CT w/ angiography ordered?

Answer 8

Acute cerebrovascular accident/TIA

With symptoms that are >6 hours and <24 hours in duration

Question 9

best study to differentiate b/w white and gray matter

Answer 9

MRI

Question 10

put these in order of what yoou should look for 1st to last: blood, bones, brain, cisterns, ventricles

Answer 10

BLOOD, CISTERNS, BRAIN, VENTRICLES, BONES

Question 11

what does black blood on CT indicate

Answer 11

ischemia or old blood

Question 12

MCA dot sign

Answer 12

Thromboembolic occlusion of the distal MCA branches in the Sylvian fissure

Question 13

subdural hematoma: venous or arterial?

Answer 13

venous

Question 14

describe a what a subdural hematoma looks like on CT

Answer 14

Crescent/banana shaped, dark hypodensity

Question 15

epidural hematoma: venous or arterial?

Answer 15

arterial

Question 16

what color is fresh blood on CT?

Answer 16

bright white

Question 17

white spots on CT are usually what?

Answer 17

hemorrhage

Question 18

what does bright white CSF in ventricles indicate on CT?

Answer 18

subarachnoid hemorrhage

Question 19

what can cause a midline shift?

Answer 19

Tumor, hemorrhage, abscess

Question 20

will old blood be hypo or hyperattenuated on CT?

Answer 20

hypo

Question 21

brain tumor: hypo or hyperattenuated on CT w/o contrast? T1 MRI? T2 MRI?

Answer 21

Hypoattenuation on head CT wo contrast
Hypoattenuation on T1 MRI
Hyperattenuation on T2 MRI

Question 22

will edema be hypo or hyper attenuated on T2MRI?

Answer 22

hyper

Question 23

hydrocephalus classic triad

Answer 23

Gait instability, urinary incontinence, dementia

Question 24

hydrocephalus best imaging. what will it look like?

Answer 24

Ventriculomegaly on CT imaging

MRI is superior imaging for this

Question 25

Depressed fractures definition

Answer 25

Displaced more than width of bone

Question 26

indications for head CT

Answer 26

Trauma Severe headache, esp “worst HA of my life” or ASW neuro deficits Stroke/CVA/TIA

Question 27

ideal timeframe to CT a pt w/ suspected subarachnoid hemorrhage

Answer 27

<6 hours

Question 28

gold standard test for diagnosing SAH after 6 hrs

Answer 28

lumbar puncture (abscense of RBCs will r/o)

Question 29

Afib could cause what type of stroke?

Answer 29

embolic ischemic

Question 30

causes of hemorrhagic stroke

Answer 30

Hypertensive vasculopathy Cerebral amyloid angiopathy Arteriovenous and other vascular malformations cerebral venous thrombosis

Question 31

risk factors for hemorrhagic stroke

Answer 31

Risk factors: Hypertension Increasing age Anticoagulant use

Question 32

test to rule out hemorrhage stroke

Answer 32

head CT w/o contrast

Question 33

risk factors for ischemic stroke

Answer 33

``` Hypertension Atherosclerotic disease Carotid stenosis/occlusion Atrial fibrillation Cardiac tumors Congenital heart disease Cardiomyopathy Patent foramen ovale Valvular disease/mechanical heart valves Sickle cell disease Hypercoagulable states ```

Question 34

will you see any signs of ischemic stroke on CT if b/w 0-4 hrs?

Answer 34

no, but might see MCA dot sign

Question 35

what study to get for: Vertigo Occult CVA/TIA Multiple sclerosis Headache (esp chronic or migraines—want to rule out structural cause) Dementia/memory loss (rule out structural cause) Hydrocephalus (plus CSF flow study)

Answer 35

Brain MRI without contrast

Question 36

``` what imaging to get for: Tumor/metastatic disease Seizures (new) Follow-up on confirmed CVA/TIA Infection/Abscess Cranial nerve neuropathy Pituitary gland dysfunction ```

Answer 36

brain MRI w/ and w/o contrast

Question 37

what study to get for: Aneurysm/Arteriovenous malformation Acute CVA/TIA if patient thrombectomy candidate and CTA inconclusive

Answer 37

brain MRI w/ angiography

Question 38

what imaging to get for: | Cavernous sinus thrombosis

Answer 38

Brain MRI with venography

Question 39

4 categories x-ray is best for

Answer 39

bone trauma, osteoarthritis, skeletal malignancy, FBs

Question 40

1st line imaging for injury to vertebrae

Answer 40

CT w/o contrast

Question 41

preferred imaging for spinal cord or spine soft tissue injury

Answer 41

MRI

Question 42

orthogonal views

Answer 42

images taken at 90 degree angle to each other

Question 43

minimum # of views when ordering xray

Answer 43

2