CTC Neurorad

Question 1

Osmotic demyelination

Answer 1

Central pons spares peripheral fibres and CS tracts - trident
Also basal ganglia thalamus cerebellum and even cerebral WM

Dwi first then T2 bright

Question 2

Wernicke

Answer 2

Confusion ataxia ophthalmoplegia 
B1 thiamine
Dorso Medial thalamus
Periaqueductal GM
Mammillary bodies
Textual plate
T2 bright enhances and restricts

Question 3

Machiafava bignami

Answer 3

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

Question 4

T1 bright basal ganglia

Answer 4

Wilson
Manganese in tpn or liver failure
Liver failure
Non ketotic hyperglycaemia

Question 5

Methanol

Carbon monoxide

Answer 5

Meth put amen can be haemorrhagic
Cm gp

Ct hypo T2 hyper

Question 6

Pres

Answer 6

T1 dark T2 bright can enhance usually doesn’t restrict (cva) vasogenic oedema

Eclampsia htn chemo

Question 7

Toxic encaphalopathies

Answer 7

Non specific T2 hyper intensity cc and periventric wm can restrict or enhance

Eg methotrexate radiation chasing the dragon …

Question 8

Ring enhance

Answer 8

Met abscess gbm infarct contusion demyelination radiation

Dwi infarct abscess (not tb toxo) lymphoma gbm medulloblastoma demyelination cjd herpes epidermoid

Question 9

Ms words

Answer 9

Devic nmo
Marburg- fulminant often tunefactive
Tumefactive ms and tumefactive demyelination
Balo concentric sclerosis
Hurst acute haemorrhaging leukoencephalitis

Question 10

Cadasil vs melas

Answer 10

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

Question 11

Neurodegen

Answer 11

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

Question 12

Leukodystrophies

Answer 12

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

Question 13

Bleeding cerebral mets

Answer 13

Melanoma rcc cholangiocarcinoma thyroid

Breast bronchigenic

Question 14

Cortically based

Answer 14

Pleomorphic xanthoastrocytoma
Dysembryonic neuroepithelial tumour
Oligodendroglioma
Ganglioglioma

Question 15

Neonatal infections

Answer 15

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

Question 16

temporal bone fractures

Answer 16

most important ?otic capsule violated
longitudinal more common more ossicle dislocation and conductive HL
transverse more carotid/jugular/facial n injury and SNHL

Question 17

middle ear lesions

Answer 17

cholesteatoma -pars flaccida, pars tensa
glomus tympanicum
dehiscent jugular bulb or aberrant carotid artery
otitis media
cholesterol cyst

Question 18

inner ear lesions

Answer 18

otosclerosis - fenestral, retrofenestral
labyrinthitis, labyrinthitis ossificans, large vesibular aqueduct (Mondini association), ELST, facial nerve-bells palsy or ramsey hunt, SSC dehiscence, Michel aplasia

Question 19

petrous apex

Answer 19

apicitis, cholesterol granuloma t1, cholesteatoma dwi, anymmetric marrow

Question 20

external ear

Answer 20

necrotic otitis externa diabetic pseudomonas, EAC SCC, EAC exostosis (swimmers), EAX osteoma

Question 21

salivary gland ducts

Answer 21

stenson parotid, wharton SM, rivinus SL

Question 22

odontogenic lesions

Answer 22

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

Question 23

parotid lesions

Answer 23

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

Question 24

carotid space

Answer 24

move pps anteriorly
glomus vagale, CB paraganglioma
schwannoma 9/10/11/12 or nurofibroma

Question 25

masticator

Answer 25

moves pps posteromedial
odontogenic infection
rhabdomyosarcoma, chondrosarcoma
cavernous haemangioma
perineural spread
v3 nerve sheath tumour