Brain Radiology

Question 1

The arrows point to which structures?

Answer 1

Frontal lobe

Parietal lobe

Occipital lobe

Question 2

The arrows point to which structures?

Answer 2

Temporal lobe

Cerebellum

Question 3

The arrows point to which structures?

Answer 3

Interhemispheric fissure

Anterior horn of the lateral ventricle

Question 4

The arrows point to which structures?

Answer 4

Suprastellar cistern

Quadrigeminal cistern

Question 5

What is the blue section?

Answer 5

Parietal lobe

Question 6

What is the pink section?

Answer 6

Midbrain

Question 7

How can you determine the side of an image?

Answer 7

Patient facing you or feet first

Question 8

In a T1-weighted image, fluid is…

Answer 8

Black

Question 9

In a T2-weighted image, fluid is…

Answer 9

White

Question 10

What are the 3 causes of stroke?

Answer 10

Embolism, thrombosis or arterial dissection

Question 11

Face, leg, arm weakness suggests that which territory is affected?

Answer 11

Middle cerebral artery

Question 12

Which artery is most commonly dissected?

Answer 12

Vertebral artery

Question 13

Which imaging modality should be used in stroke?

Answer 13

Non-contrast enhanced CT

Question 14

How long after the onset of symptoms of stroke can thrombolysis be given?

Answer 14

Up to 4.5 hours

Question 15

What is the earliest sign of a stroke on CT?

Answer 15

• thrombus in vessel – hyperdense

Question 16

What does this show?

Answer 16

Thrombus in middle cerebral artery

Question 17

Which changes occur in infarct stroke after a few hours on CT?

Answer 17

loss of grey-white matter differentiation & hypoattenuation of deep nuclei, wedge-shape, swelling

Question 18

Which process occurs long-term in an infarct?

Answer 18

Liquefactive necrosis - gliosis

Question 19

What is meant by an intra-cranial haemorrhage?

Answer 19

within the brain substance

Question 20

Where is a sub-dural haemorrhage?

Answer 20

Between dura and arachnoid mater

Question 21

How does a subdural haemorrhage occur?

Answer 21

Tearing of bridging veins

Question 22

In which groups do subdural haemorrhages occur?

Answer 22

• Usually in elderly
• Infants – NAI

Question 23

Which type of haemorrhage will cross sutures but not the midline?

Answer 23

Subdural

Question 24

Which pathology is shown here?

Answer 24

Intra-cerebral haemorrhage

Question 25

Which pathology is shown here?

Answer 25

Extra-dural haemorrhage

Question 26

What is the pathology?

Answer 26

Subdural haemorrhage

Question 27

How does a subdural haemorrhage change over time?

Answer 27

* Isodense homogenous over time * Chronic – hypodense

Question 28

Which pathology is seen here?

Answer 28

Acute on chronic sub-dural haemorrhage

Question 29

Which type of bleed will not cross suture lines?

Answer 29

Extra-dural

Question 30

Which type of bleed is associated with a lucid interval?

Answer 30

Extra-dural

Question 31

Which pathology is seen here?

Answer 31

Sub-arachnoid haemorrhage

Question 32

If a non-traumatic sub-arachnoid haemorrhage is confirmed by CT, what is the next investigation?

Answer 32

CT cerebral angiography

Question 33

What is the rule about the likely origin of intra-cranial tumours?

Answer 33

Adults - more likely to be metastasis Children - more likely to be primary brain tumour

Question 34

Which cancers most commonly metastasise to the brain?

Answer 34

lung, breast, melanoma, renal cell, and colorectal cancers

Question 35

What is usually the first test if you suspect a brain tumour?

Answer 35

CT head

Question 36

Which tumours are most likely to enhance?

Answer 36

More aggressive tumours

Question 37

What is tonsillar herniation?

Answer 37

Descent of the cerebellar tonsils below the foramen magnum

Question 38

Clinically, tonsillar herniation is called...

Answer 38

Coning

Question 39

Why are children with brain tumours more susceptible to developing hydrocephalus?

Answer 39

Posterior fossa – pushes on 4th ventricle

Question 40

Where does the spinal cord end approximately?

Answer 40

L1

Question 41

Which imaging modality should be used in spinal cord compression?

Answer 41

MRI spine

Question 42

Where do the spinal nerves arise?

Answer 42

Below its vertebral body - apart from in cervical region (arise above)

Question 43

What kind of weighted image is this?

Answer 43

T2- weighted as CSF is white