Brain Radiology Flashcards
The arrows point to which structures?
Frontal lobe
Parietal lobe
Occipital lobe
The arrows point to which structures?
Temporal lobe
Cerebellum
The arrows point to which structures?
Interhemispheric fissure
Anterior horn of the lateral ventricle
The arrows point to which structures?
Suprastellar cistern
Quadrigeminal cistern
What is the blue section?
Parietal lobe
What is the pink section?
Midbrain
How can you determine the side of an image?
Patient facing you or feet first
In a T1-weighted image, fluid is…
Black
In a T2-weighted image, fluid is…
White
What are the 3 causes of stroke?
Embolism, thrombosis or arterial dissection
Face, leg, arm weakness suggests that which territory is affected?
Middle cerebral artery
Which artery is most commonly dissected?
Vertebral artery
Which imaging modality should be used in stroke?
Non-contrast enhanced CT
How long after the onset of symptoms of stroke can thrombolysis be given?
Up to 4.5 hours
What is the earliest sign of a stroke on CT?
- thrombus in vessel – hyperdense
What does this show?
Thrombus in middle cerebral artery
Which changes occur in infarct stroke after a few hours on CT?
loss of grey-white matter differentiation & hypoattenuation of deep nuclei, wedge-shape, swelling
Which process occurs long-term in an infarct?
Liquefactive necrosis - gliosis
What is meant by an intra-cranial haemorrhage?
within the brain substance
Where is a sub-dural haemorrhage?
Between dura and arachnoid mater
How does a subdural haemorrhage occur?
Tearing of bridging veins
In which groups do subdural haemorrhages occur?
- Usually in elderly
- Infants – NAI
Which type of haemorrhage will cross sutures but not the midline?
Subdural
Which pathology is shown here?
Intra-cerebral haemorrhage
Which pathology is shown here?
Extra-dural haemorrhage
What is the pathology?
Subdural haemorrhage
How does a subdural haemorrhage change over time?
- Isodense homogenous over time
- Chronic – hypodense
Which pathology is seen here?
Acute on chronic sub-dural haemorrhage
Which type of bleed will not cross suture lines?
Extra-dural
Which type of bleed is associated with a lucid interval?
Extra-dural
Which pathology is seen here?
Sub-arachnoid haemorrhage
If a non-traumatic sub-arachnoid haemorrhage is confirmed by CT, what is the next investigation?
CT cerebral angiography
What is the rule about the likely origin of intra-cranial tumours?
Adults - more likely to be metastasis
Children - more likely to be primary brain tumour
Which cancers most commonly metastasise to the brain?
lung, breast, melanoma, renal cell, and colorectal cancers
What is usually the first test if you suspect a brain tumour?
CT head
Which tumours are most likely to enhance?
More aggressive tumours
What is tonsillar herniation?
Descent of the cerebellar tonsils below the foramen magnum
Clinically, tonsillar herniation is called…
Coning
Why are children with brain tumours more susceptible to developing hydrocephalus?
Posterior fossa – pushes on 4th ventricle
Where does the spinal cord end approximately?
L1
Which imaging modality should be used in spinal cord compression?
MRI spine
Where do the spinal nerves arise?
Below its vertebral body - apart from in cervical region (arise above)
What kind of weighted image is this?
T2- weighted as CSF is white
