CTC Neurorad Flashcards
Osmotic demyelination
Central pons spares peripheral fibres and CS tracts - trident
Also basal ganglia thalamus cerebellum and even cerebral WM
Dwi first then T2 bright
Wernicke
Confusion ataxia ophthalmoplegia B1 thiamine Dorso Medial thalamus Periaqueductal GM Mammillary bodies Textual plate T2 bright enhances and restricts
Machiafava bignami
T2 hyper intensity of CC body then genu then splenium
Due to b vitamin deficiency
Sam which sign spares dorsal and ventral fibres
Differentials are other cytotoxic lesions of the CC
- wernicke, extrapontine demyelination
- seizures, antiepileptics
- chemo
- cns infection
- large volume sah
T1 bright basal ganglia
Wilson
Manganese in tpn or liver failure
Liver failure
Non ketotic hyperglycaemia
Methanol
Carbon monoxide
Meth put amen can be haemorrhagic
Cm gp
Ct hypo T2 hyper
Pres
T1 dark T2 bright can enhance usually doesn’t restrict (cva) vasogenic oedema
Eclampsia htn chemo
Toxic encaphalopathies
Non specific T2 hyper intensity cc and periventric wm can restrict or enhance
Eg methotrexate radiation chasing the dragon …
Ring enhance
Met abscess gbm infarct contusion demyelination radiation
Dwi infarct abscess (not tb toxo) lymphoma gbm medulloblastoma demyelination cjd herpes epidermoid
Ms words
Devic nmo
Marburg- fulminant often tunefactive
Tumefactive ms and tumefactive demyelination
Balo concentric sclerosis
Hurst acute haemorrhaging leukoencephalitis
Cadasil vs melas
Cerebral AD arteriopathy with subcorticsl infarcts and leukoencepaholpathy
Spares sc u
Mitochondrial encephalopathy with lactic acidosis and stroke like episodes doesn’t also younger
Susac looks similar to cadasil but more focal
CNS vasculitis
Subcortical arteriosclerotic encephalopathy like cadasil but older assoc htn
Neurodegen
Alzheimers extracellular ab amyloid intercellular tauopathy nf tangles
Hippocampi, temporoparietal
Multi infarct
Picks frontotemporal
Lest body alpha synuclein Lewy bodies lose swallow tail SN nitro some 1 affects occipital lobes
Leukodystrophies
Alexander ad rosenthal fibres frontal lobes hits u fibres macrocephaly enhances
Canavan can’t metabolise naa Jews ar hits u fibres can restrict macrocephaly
Metachromatic ar lysosomal storage periventicular butterfly Tigroid doesn’t enhance spares u
Xlald peroxisomal vlcfa parietooccipital enhances and restricts spares u
Bleeding cerebral mets
Melanoma rcc cholangiocarcinoma thyroid
Breast bronchigenic
Cortically based
Pleomorphic xanthoastrocytoma
Dysembryonic neuroepithelial tumour
Oligodendroglioma
Ganglioglioma
Neonatal infections
Most common is cmv get periventricular calcifications polymicrogyria
Toxo 2nd get basal ganglia and scattered calcifications and hydrocephalus
HSV targets endothelium giving haemorrhagic infarcts and thrombus causes hydraencephaly
temporal bone fractures
most important ?otic capsule violated
longitudinal more common more ossicle dislocation and conductive HL
transverse more carotid/jugular/facial n injury and SNHL
middle ear lesions
cholesteatoma -pars flaccida, pars tensa glomus tympanicum dehiscent jugular bulb or aberrant carotid artery otitis media cholesterol cyst
inner ear lesions
otosclerosis - fenestral, retrofenestral
labyrinthitis, labyrinthitis ossificans, large vesibular aqueduct (Mondini association), ELST, facial nerve-bells palsy or ramsey hunt, SSC dehiscence, Michel aplasia
petrous apex
apicitis, cholesterol granuloma t1, cholesteatoma dwi, anymmetric marrow
external ear
necrotic otitis externa diabetic pseudomonas, EAC SCC, EAC exostosis (swimmers), EAX osteoma
salivary gland ducts
stenson parotid, wharton SM, rivinus SL
odontogenic lesions
radicular/periapical cyst
dentigerous cyst
OKC - unilocular 50% or multilocular, t1 bright and DWI dont enhance
Ameloblastoma (craniopharyngioma) multiloculated expansile and enhance
odontoma, condensing osteiitis, cementoosseous dysplasia
parotid lesions
move parapharyngeal space anteromedially
gland - 1. b9pleiomorphic adenoma/benign mixed tumour (also 50% lacrimal)
2. b9warthin-often cystic, old male smokers, 20% bilat
3. mucoepidermoid - bad
4. adenoid cystic - real bad - perineural spread
basically PA/W/low grade ME or AC look same
nodal met
HIV benign lyphoepithelial disease - also nodes and tonsils
sjogrens - get marginal Z lymphoma
parotitis -bacterial-sialolithiasis/mumps
carotid space
move pps anteriorly
glomus vagale, CB paraganglioma
schwannoma 9/10/11/12 or nurofibroma
masticator
moves pps posteromedial odontogenic infection rhabdomyosarcoma, chondrosarcoma cavernous haemangioma perineural spread v3 nerve sheath tumour
