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CLASP - Radiology > Brain Masterclass > Flashcards

Brain Masterclass Flashcards

1
Q

first line imaging in the brain?

A

CT

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2
Q

contrast enhanced vs non contrast enhanced CT in brain?

A

grey and white matter better differentiated in contrast enhanced

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3
Q

suprasellar cisteren?

A

star shaped dark area which sits more forward in brain CT

where the circle of willis sits

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4
Q

quadrigeminal cistern?

A

half circle shaped dark area in middle of brain

sits behind brainstem and suprasellar cistern

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5
Q

learn midline slice MRI>

A 
...
featues 
- thalamus
- midbrain
- pons
- medulla
- caudate nucleus
- cingulate gyrus
- frontal lobe
- parietal lobe
- occipital lobe
- anterior and posterior lobe of cerebellum
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6
Q

difference between cerebrum and cerebellum

A

gyri are finer in cerebellum (foliae)

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7
Q

T1 weighted?

A

fluid is black

better for seeing anatomy

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8
Q

T2 weighted?

A

fluid is white

better for seeing pathology

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9
Q

purely frontal lobe stroke?

A

executive function

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10
Q

visual disturbance and vertigo are features of a stroke where?

A

posterior circulation

occipital lobe or cerebellum

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11
Q

main 3 causes of ischaemic stroke?

A

embolism
thrombosis (plaque rupture etc)
vertebral artery dissection

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12
Q

common source of stroke in cerebellar circulation?

A

vertebral > basillar > posterior inferior cerebellar areries

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13
Q

why is imaging used in stroke even it is a clinical diagnosis?

A

management

- different is ischaemic or haemorrhagic etc

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14
Q

window for thrombolysis in ischaemic stroke?

A

6 hours

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15
Q

is contrast used in CT for stroke?

A

no

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16
Q

is thrombolysis given is established stroke is found (7 hours - 1 day+)?

A

no

17
Q

early findings on CT?

A

hyperdense segment of a vessel and matching features

18
Q

finding s within first few hours?

A

loss of grey white matter differentiation
hypoattenuation of deep nuclei
cortical hypodensity with associated parenchymal swelling with resultant grey matter engulfmant

19
Q

within a few more hours what is seen?

A

hypoattenuation and swelling become more marked resulting in a significant mass effect
larger dark area

20
Q

with even more time?

A

gliosis occurs appearing as a region of low density with volume loss
darker, slighly smaller and more defined area than earlier hypoattenuation

21
Q

acute blood and clots appears like what on CT?

A

white

22
Q

2 types of intracranial haemorrhage?

A 
intra-axial
- intra-parenchymal
- e.g burst lobe/lobar haemorrhage
- often causes midline shift
extra-axial
- outside of brain tissue
- extra-dural haemorrhage
- subdural haemorrhage
- subarachnoid haemorrhage
23
Q

classic place for hypertensive bleed?

A

basal ganglia
thalamus
etc

24
Q

main signs of subarachnoid haemorrhage?

A

white star shaped area in middle of brain

blood may collect around circle of willis, in sulci or in ventricles

25
Q

what is done if subarachnoid blood is found in absence fo trauma?

A

CT angiogram to look for berry aneurysm

26
Q

complications of subarachnoid haemorrhage which usually cause death rather than the haemorrhage itself?

A

hydrocephalus
vasospasm
infarction

27
Q

sign of early hydrocephalus?

A

enlarged temporal horns

28
Q

first test for brain mass?

A

CT

29
Q

which type of tumour will enhance the most?

A

higher grade

30
Q

how can oedema (e.g from a brain tumour) be differentiated from blood from haemorrhage/

A

oedema doesn’t go all the way out to periphery (wedge shaped)

31
Q

which type of brain tumour generally has lots of oedema?

A

metastatic

32
Q

how does coning cause death?

A

compresses clivus against pons and medulla disrupting cardio and resp centres

33
Q

level of conus medullaris?

A

L1

in thecal sac

34
Q

presentation of spinal cord compression?

A 
back pain with red flags
- malignancy history
- major trauma
- thoracic/radicular pain
- constant, progressive, non-mechanical pain
- systemically unwell
loss of power and sensation in lower limbs
urinary retention
35
Q

investigations in spinal cord compression?

A

urgent MRI

CT can show fractures or gross malalignment but wont show cord

36
Q

signs of extra-dural haemorrhage on imaging?

A

biconvex lens shape
often overlying temporoparietal region
bound by fissures in brain

37
Q

features of sub-dural haemorrhage on imaging?

A

often from shaking baby or falls in elderly
wont cross the midline
semilunar shape on CT
subacute = isodense (looks same as brain)
chronic = hypodense (darker)

CLASP - Radiology (8 decks)

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