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Radiology > CNS > Flashcards

CNS Flashcards

1
Q

Pilocystic astrocytoma
Modality
We must take biopsy

A
  • pre & post contrast CT
  • MRI T1 brain axial with IV contrast
    RT infratentorial intraaxial cystic lesion with mural enhancement
    No need for biopsy !!!
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2
Q

CT brain axial with contrast
Ring enhanced lesion in left frontal lobe with contralateral vasogenic edema
Dx :

Can also be described as :

A

Typical for Glioblastoma
Lt glioblastoma

Heterogenous enhanced mass in corpus callosum

Ring enhanced lesion with vasogenic edema
“ check for subfalcine herniation “

Next step is biopsy

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3
Q

Brain tumour
With bilateral ring enhanced lesion in corpus callosum surrounded by vasogenic edema
Dx :
Sign :

A

Glioblastoma
Butterfly sign

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4
Q

-

A

Malignant cells invade the BBB
Or abscess

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5
Q

Meningioma
Most common site :
Type of enhancement:

A

Parasagital “ at cerebral convexities
Homogenous enhanced mass
“ may contain calcium “

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6
Q

-

A

Rat tail sign
Claw sign
+ broad base

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7
Q

-

A

Meningitis
Meningioma

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8
Q

Meningioma
Extra or Intra axial ?

A

Extra axial

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9
Q

If meningioma surrounded by vasogeniv edema =

A

Malignant meningioma

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10
Q

Calcium way of appearance on
CT
MRI

A

CT : white as skull
MRI : mass appear heterogenous

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11
Q

Differences between ring enhanced lesions in the brain :

A

Abscess
Thin regular wall , multiple : adjacent to each other

Glioblastoma : single thick irregular wall

Metastasis : single in cerebellum , multiple : away from each other

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12
Q

Suspect brain metastasis
Next step is :

A

CXR ; the commonest tumour is lung cancer

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13
Q

CT brain axial with IV contrast
Multiple enhanced lesions , one of them shows ring enhancement located in the cerebellum & basal ganglia
Dx is :

A

Metastasis

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14
Q

Acoustic shwannona
Arise from …..

A

Myelin sheath of the 8th Cranial nerve

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15
Q

Left CPA enhanced extra axial mass
History of sensorineural deafness
Dx :

A

Acoustic neuroma

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16
Q

Pre & post contrast CT brain axial
Show heterogenous enhanced extra axial mass
Ddx :

A

Acoustic shwannoma
Meningioma
Ependymoma
Neuroepithelial cyst

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17
Q

Heterogenous enhanced mass at CPA
Can be

A
  • acoustic shwannoma
  • meningioma “ with Calcium “
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18
Q

The most common intracranial malignancy in adults is ………

A

Brain metastasis

19
Q

Pituitary adenoma
Can be
Micro …
- non enhanced
- dx by ….
Most common disturbance …..

Macro ….
-enhanced
-dx by ….
- complain of ………

A

Micro <1cm
MRI only
Secondary amenorrhea

Macro >1cm
CT or MRI
-no hormonal alteration
Pressure symptoms = high ICP compressing carotid arteries & optic chiasma “ bitemporal hemianopia

20
Q

Large homogenous enhanced mass occupying sella turcica
Ddx :
Dx :

A

Pituitary macroadenoma , meningioma

Dx : pituitary macroadenoma

Large mass occupying sella turcica with mass effecy on optic mass

21
Q

MRI T1 brain axial with IV contrast
Describe acute bacterial meningitis

A

Leptomeningeal enhancement , hydrocephalus

22
Q

Leptomeningeal enhancement with pus
Dx : bacterial meningitis complicated by empyema
Modalities used :

A

MRI T1 axial with IV contrast
MRI diffusion weighted image

23
Q

MRI T1 axial brain with IV contrast
Basal enhancement witg microabscesses.
Dx :

A

Tubercuolous meningitis

24
Q

Describe viral meningitis :

A

CT axial brain with IV contrast
Hypodense edema , sulci effacement

25
Q

Describe
Brain abscess :
Management :

A

CT brain axial with IV contrast ring enhanced lesion in RT frontoparietal lobe surrounded by vasogenic edema

Antibiotic & drainage

26
Q

Ring enhanced lesion in brain
Abscess
Or
Tumour “ metastasis”

A

Absecess close to each other
Metastasis away from each other

27
Q

CT = no hge > exclude ……
Ischemic stroke =
Early “ before 6 hours :……..
6-12 hrs : ……

A

Hemorrhagic stroke
CT normal

Dense artery sign : cytotoxic edema lead to
Sulci effacement ; poor differentiation between grey & white

28
Q

Dense artery
Sulci effacement indicate :

A

Hyperacute ischemic stroke

29
Q

Hyperacute I S :
Describe

A

CT brain axial without Iv contrast
Dense artery sign , sulci effacement
Finding follow right middle cerebral artery territory

30
Q

Acute ischemic stroke
describe

A

Wedge shaped edema follow Lt middle cerebral artery territory

31
Q

Encephalomalacia follow MCA terrirory

A

Lt chronic ischemic stroke
No need for Treatement

32
Q

Diagnosis of ischemic stroke within 30 min from onset of symptoms can be done by :

A

Diffusion weighted imaging

33
Q

-
-
-

A

Intraventricular hemorrhage
Subarachnoid hemorrhage
Acute parenchymal hemorrhage
Acute pontine hemorrhage

34
Q

Most common cause of hemorrhagic stroke :

Other causes :

A

HTN
At basal ganglia

Arteriovenous malformation rupture
Cancer
Berry’s aneurysm
Bleeding disorder

35
Q

H/O of chronic headache
Carotid angiogram
Digital subtraction angiogram
Dx of ….
Complications:……

A

Arteriovenous malformation
Rupture & hemorrhagic stroke

36
Q

Berry aneurysm can be diagnosed with ……..
Complication ……

A

Digital subtraction angiogram DSA
Rupture & hemorrhagic stroke

37
Q

CT brain axial without IV contrast
Hyperdense parenchymal hemorrhage occupying left basal ganglia
Dx :
Most like cause :

A

Left acute parenchymal hemorrhage

Hypertension

38
Q

Hyperdense hge occupying the sulci
Dx :

A

Subarachnoid hge

39
Q

Parenchymal hemorrhage with vasogenic edema
Most like the cause is :……

A

Cancer

40
Q

Hyperdense hge occupying the pons

A

Acute pontine hemorrhage

41
Q

Most common sites of diffuse axonal injury :

A

Junction between white & grey matter
Corpus callosum
Basal ganglia
Brian stem

42
Q

Brain contusion appear as
Can be

A

Hemorrhagic foci always acute
Coup , counter coup or both

43
Q

Diffuse axonal injury diagnosed by :
Hypointense dots

A

MRI T2 star
Appear as hypointense dots

44
Q

Signs of acute ischemic stroke

A

Dense artery sign
Poor differentiation between grey & white matter
Sulci effacement

Radiology (8 decks)

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