differentials for neuro Flashcards
Spine tumor intramedullary
astrocytoma: children, cyst/syrinx, solid portion T1 iso, T2 hyper, heterogenous enhance
ependymoma: adult, often hemorrhagic leading to heterogenous MR appearance. T1 iso, T2 hyper, avid homo enhance. NF2 if in kids.
Hemangioblastoma: cyst formation, T1 iso, T2 hyper, marked enhance, numerous flow voids. VHL
Demyelinating: absence of cord expansion.
ganglioglioma/gangliocytoma: Mixed T1, T2 hyper with patchy enhancement. young adults, long segment involvement over 8 vertebral bodies, scoliosis and bony remodeling
paraganglioma salt and pepper appearance in the conus/cauda equina region.
Carotid space mass
Paraganglioma: intense enhance, salt+pepper/flow void
- carotid body: splays ICA and ECA
- vagal nerve: displaces ICA and ECA anteromedially
Schwannoma (often of vagus): does not enhance as homogenously. displaces ICA and ECA anteromedially
Neurofibroma: cannot distinguish from schwannoma.
Periventricular enhancement
Primary CNS lymphoma
Infectious ependymitis
primary glial tumor
MS
Gyriform Enhancement
Herpes encephalitis
meningitis
Subacute infarct
PRES
Benign parotid neoplasm
Pleomorphic adenoma: like water but enhances. T1 hypointense, T2 hyperintense, enhancing circumscribed mass
Warthin tumor: cystic (T1 dark, T2 brighht) but does not enhance
Malignant parotid neoplasm
- Mucoepidermoid carcinoma (T1 hypo, T2 bright, enhancing, cannot differentiate from pleomorphic adenoma)
- adenoid cystic carcinoma (enhancing mass with perineural spread)
- carcinoma ex pleomorphic adenoma (T1 hypo, T2 hypo)
- squamous cell carcinoma
Tumors with a cyst and an enhancing nodule
Juvenile Pilocytic Astrocytoma
Hemangioblastoma
Ganglioglioma
Pleomorphic Xanthoastrocytoma (PXA)
High attentuation or increased FLAIR signal in sucharachnoid space
Subarachnoid hemorrhage
meningitis
leptomeningeal carcinomatosis
contrast ( intrathecal )
Ring enhancing lesion
MAGIC DR mets abscess glioma infarct contusion
demyelinating dz (incomplete ring) radiation
pachymeningeal enhancement
intracranial hypotension
any kind of postop involving tear of dura
meningeal neoplasm
granulomatous dz.
Leptomeningeal enhancement
meningitis
leptomeningeal carcinomatosis
viral encephalitis
slow vascular flow (GE FLAIR can suppress this)
Tumors with a cyst and an enhancing nodule
Pilocytic astrocytoma
Hemangioblastoma
Pleomorphic Xanthoastrocytoma (PXA)
Ganglioglioma
Extramedullary Intradural Lesion
Nerve sheath tumor (schwannoma and neurofibroma): T1 iso T2 hyper with enhancement. Can have bleeding/calc with hypo on T2. Central hypo with peripheral hyper target sign on T2 is suggestive
Meningioma
Dermoid (fat)/Epidermoid cyst
Arachnoiditis.
extra axial tumor
meningioma schwannoma hemangiopericytoma neurofibroma neuroma Mets
Intraventricular mass
Choroid plexus papilloma
Choroid plexus carcinoma
Choroid plexus hemangioma
Choroid plexus xanthogranuloma
Meningioma Ependymoma Central neurocytoma Epidermoid cyst Dermoid Teratoma Lipoma
Astrocytoma
Grade 1
Pilocytic astrocytoma
Pleomorphic Xanthoastrocytoma
Subependymal giant cell astrocytoma
Grade 2
Diffuse astrocytoma
Brain stem glioma
Grade 3
anaplastic astrocytoma
Gliomatosis cerebri
Grade 4
Glioblastoma
Gliomatosis cerebri
Corpus callosal mass lesions
Glioblastoma
Lymphoma
MS PML Adrenoleukodystrophy Marchiafava Bignami disease PRES
Lipoma
cyst
Susac
Embryonal Tumors
Medulloblastoma
Supratentorial PNET
ATRT
DNET
Temporal Lobe Lesions
- ganglioglioma
- astrocytoma
- DNET
- oligodendroglioma
- PXA
- DIG
Mixed neuronal and glial tumor
- ganglioglioma
- DIG
- oligodendroglioma
Calcified CNS
Oligodendroglioma
Ganglioglioma
Astrocytoma
Ependymoma
Meningioma Craniopharyngioma Pineal tumor Ependymoma Neurocytoma Choroid plexus papilloma
Pineal region germ cell neoplasms
Germinoma
Teratoma
Choriocarcinoma
Yolk sac tumor
Pineal region non-germ cell neoplasm
Pinealblastoma
Pineocytoma
Astrocytoma
Intrasellar lesions
Congenital lesions ( Rathke cleft cyst, aplasia/hypoplasia, ectopia) pituitary adenoma pituitary apoplexy meningioma aneurysm
granulomatous (LCH, sarcoid)
lymphocitic hypophysitis
Suprasellar lesions
Rathke cleft cyst arachnoid cyst craniopharyngioma meningioma chiasmatic and hypothalamic astrocytoma hamartoma of the tuber cinereum aneurysm
epidermoid, dermoid, teratoma, lipoma
granulomatous (LCH, sarcoid)
germinoma
parasellar lesions
meningioma
schwannoma
chondrosarcoma
aneurysm
carotid cavernous fistula
thrombosis of the cavernous sinus
tolosa hunt syndrome
Skull base lesions
meningoencephalocele
juvenile angiofibroma
chordoma/chondrosarcoma
fibrous dysplasia
