Chapman & Nakielny Flashcards by Jacqueline Chu

What is the most common extradural mass?

Disc herniation/extrusion/sequestration

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An extradural mass (unilocular cyst) that’s related to facet joint arthrosis

Synovial cyst

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Extradural meningeal cysts include the following

Perineural cyst (along spinal nerve, usually within neural foramen)
Arachnoid cyst (within spinal canal, usually posterior)
Tarlov cyst (typically at the sacrum)

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What are the 4 most common intradural extra medullary masses?

Schwannoma (most common)
Meningioma
Neurofibroma
Arachnoid cyst (follows CSF signal on all sequences)

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What are the 3 most common intramedullary masses?

Ependymoma (most common intramedullary tumor in adults)
Astrocytoma (most common intrarmedullary tumor in children)
Haemangioblastoma

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What is the most common location for transverse myelitis?

Thoracic region (no brain/optic nerve involvement)

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ADEM (acute monophonic postinfective autoimmune disorder) is most likely seen in which age range?

Children/adolescents

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This tumor accounts for 90% of tumors arising from the filum terminale

Myxopapillary ependymoma (ME)

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Fatty thickening of the filum terminale with/without cord tethering is most likely what kind of mass?

Filum terminale lipoma

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The parapharyngeal space contains primarily fat, small vessels, and small nerves. Where is this space located?

Between the parotid, masticator, carotid and pharyngeal mucosal spaces

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A mass within the deep lobe of the parotid gland will displace parapharyngeal fat in which direction?

Medially

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Pathology within the masticator space will displace parapharyngeal fat in which direction?

Posteriorly

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A mass within the carotid space will displace parapharyngeal fat in which direction?

Anteriorly

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A mass within the pharyngeal mucosal space will displace parapharyngeal fat in which direction?

Laterally

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List the most common pharyngeal mucosal space (nasopharynx) lesions

Nasopharyngeal carcinoma (SCC or undifferentiated)
Lymphoma
Lymphoid hyperplasia
Tornwaldt cyst

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List the most common pharyngeal mucosal space (oropharynx) lesions

Tonsil SCC (lingual: tongue based, faucial: palatine based)
Palatine tonsil inflammation/abscess
Lymphoma

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Tonsil squamous cell carcinoma (SCC) is highly associated with smoking as well as which virus?

HPV

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List the most common masticator space lesions

Abscess (secondary to dental infection, osteomyelitis of mandible)
Bony lesions of mandible 
Masticator muscle hypertrophy (benign)
Masticator space pseudo-lesions (benign)
Motor denervation of CN VIII

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What are 3 top considerations for a focal parotid space lesion?

Pleomorphic adenoma (80% of parotid tumors)
Warthin tumor (second most common, often in the tail)
Lymphoma/nodular metastasis 
Salivary glad carcinomas

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Pleomorphic adenomas of the parotid gland has what kind of appearance?

Well-defined
Lobulated mass
Homogenous when small
Hetrogenous when large

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Along with parotitis, what else can explain diffuse enlargement of the parotid gland?

Sjogrens syndrome

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What are 3 common carotid space lesions?

Carotid body paraganglioma (most common paraganglioma of the head and neck, located at carotid bifurcation)
Vagal schwannoma
Jugular vein thrombosis

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The perivertebral space contains which 2 compartments?

Prevertebral

Paraspinal

What are some common perivertebral space lesions?

Vertebral body metastasis
Infection
Schwannoma

What are some common posterior cervical space lesions?

``` Lymphadenopathy, can be caused by: Metastatic SCC Thyroid malignancies Lymphoma Other lesions to consider: Brachial cleft cyst Nerve sheath tumor (eg. schwannoma, neurofibroma) ```

What are some common focal retropharyngeal space lesions?

Reactive lymph node (common in children) Metastatic lymphoma node Lymphoma

What are some common diffuse retropharyngeal space lesions?

Abscess Effusion Suppurative adenopathy Longus colli tendonitis

What are the 3 most common oral mucosal space lesions?

SCC Minor salivary gland carcinoma Radiation mucositis

What are some common sublingual space lesions

Simple ranula (post-inflammatory sublingual mucous retention cyst) Abscess Sublingual gland carcinoma (90% of sublingual masses are malignant, most common is an adenoid cystic)

50% of submandibular space lesions are what?

Pleomorphic adenoma of submandibular gland (SMG)

What are some common lesions at the root of the tongue?

Abscess SCC invasion (from tongue or floor of the mouth) Thyroglossal duct cyst

What are some common laryngeal lesions?

SCC Vocal cord paralysis Laryngocele (air/fluid-filled cystic dilatation of laryngeal ventricle)

Thyroid enlargement caused by thyroiditis can be seen in which autoimmune diseases?

Hashimotos thyroiditis Graves disease Riedels thyroiditis Postpartum thyroiditis

Most of the cystic lesions seen in the mandible/maxilla are _____ in origin

Odontogenic

What are the 3 most common cysts of the mandible/maxilla?

Periapical (radicular) cyst: at the apex of a dead tooth Nasopalatine duct cyst: asymptomatic developmental cyst Dentigerous cyst: developmental cyst associated with crown of unerupted/impacted toot

What are some common solid bony lesions of the mandible/maxilla?

Malignant infiltration by adjacent tumor (most common: SCC) Myeloma (most common at posterior mandible) Metastasis Lymphoma

What are 3 causes of a sclerotic/calcified/ossified bony lesion at the mandible/maxilla?

Osteoma Metastasis Exostosis (aka torus)

Factoids about fibrous dysplasia of the mandible/maxilla

Face/calvarium involvement in 25% of monostotic FD > 50% involvement in polyostotic FD Maxilla > mandible

What is the most common primary intraocular tumor in adults?

Melanoma (usually arises from choroid)

What are the most common lesions of the optic nerve/sheath?

Optic nerve sheath meningioma (seen in 4th-5th decade) Optic pathway glioma (associated with NF1) Optic neuritis (5-15 years old, autoimmune inflammation is associated with multiple sclerosis)

What is the most common epithelial tumor of the lacrimal gland?

Pleomorphic adenoma

What are some causes of diffuse/multifocal skull base lesions?

``` Metastasis Pagets disease Fibrous dysplasia Myeloma Osteomyelitis ```

What are some common lesions seen at the clivus?

Nasopharyngeal carcinoma Pituitary adenoma Chordoma

What are 3 common causes of acute solitary intracranial hemorrhage (intracerebral)?

Hypertension (basal ganglion, pons, cerebellum) Cerebral amyloid angiopathy (lobar location) Hemorrhagic lesions (eg. metastasis, primary tumors, infarcts)

What is the most common cause of subarachnoid hemorrhage (SAH)?

Trauma (most commonly seen in the elderly)

Aside from trauma, what are some other common causes of SAH?

Intracranial aneurysm Arteriovenous shunt Vasculopathy

Trauma is the most common cause of multifocal acute intracerebral hemorrhage, what is the most common location?

Contusions: anteroinferior frontal lobes and temporal poles | Hemorrhagic shear injury: grey-white matter junction, corpus callosum, brainstem

Aside from trauma, what are some other causes of multifocal acute intracerebral hemorrhage?

Septic embolism Hemorrhagic neoplastic lesions Coagulopathy

Enlargement of temporal horns of lateral ventricles Ventricles disproportionately enlarged compared to sulci Blunted third ventricular recesses Evidence of periventriculars CSF transudation These are all indicators of what?

Hydrocephalus

CSF over production is caused by?

Choroid plexus tumors (eg. papilloma, carcinoma)

Ventricular enlargement can be seen with which 3 common causes?

Hemorrhage Intraventricular tumors Ventriculitis

Deep grey matter calcification, typically seen in middle-aged patients and has a symmetrical pattern is characteristic of which pathology?

Fahr disease

Calcified subependymal nodules associated with cortical tubers is a hallmark of which pathology?

Tuberous sclerosis

Sturge-Weber syndrome is associated with what kind of intracranial calcification?

Usually unilateral with associated cerebral atrophy Look for: Retinal enhacement Ipsilateral choroid plexus enlargement

Where does a craniopharyngioma arise from?

Suprasellar location (calcification is common)

What is the most common posterior fossa mass in an adult?

Metastasis (most common infratentorial lesion)

What is the most common posterior fossa mass in a child/young adult?

Ependymoma (floor of the fourth ventricle)