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3 differentials > head and neck > Flashcards

head and neck Flashcards

1
Q

Cholesteatoma

Hx- hearing loss

A
  • soft tissue mass in epitympanum
    • congenial
      • Medial to ossicles
      • intact ear drum
      • less erosions
    • Acquired
      • Lateral to ossicles
      • erosion of scutum
  • ? in contact with incus
  • ? erosions
  • ? facial canal patency
  • ? facial nerve normal
  • ? LESION IN NASOPHARYNX
  • DWI
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2
Q

Petrous apex cholesterol granuloma

Hx

-Headache

- Well patient

A

* Describe study

  • Lesion centred on petrous apex
    • Well defined
    • Expansile
    • Related to carotid canal
    • No cortical breach
  • MRI
    • Define anatomy
    • characterise
    • Does not enhance- exclude carotid aneurysm
    • Restricted Diffusion
  • Gold medal
    • Check nasoparynx
    • Look at contralateral temporal bone
  • Differentials
  1. cholesterol granuloma
  2. Cholesteatoma
  3. Mucocele
  4. Nerve sheath tumour
    1. trigeminal
  5. Chondrosarcoma
  6. Nasopharyngeal carcinoma
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3
Q

Ossicle dislocation

Hx- conductive hearing loss

A
  • Look for fracture
  • Describe transverse or longitudinal
  • Types
    • Maeelo-incal
    • inco-stapedial
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4
Q

Ranula

Hx- Mass under chin,

patient well

A
  1. Describe exam
  2. Location
    1. Submandibular
    2. Extends into sublingual space
  3. Cystic lesion
  4. Borders
  5. Enancement

Differential

  1. Ranula
  2. Lymphangioma ( fluid/fluid levels)- Work up with MRI
  3. Epidermoid

Managment

  • Aspirate
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5
Q

BILATERAL mastoid air cell opacification

Hx-

WELL patient

A
  1. Describe scan
  2. Bilateral mastoid opacification
  3. Other
    1. Mass in nasopharynx
    2. Erodes clivus
    3. ? calcifcation
  4. Nodes
  5. Synchronous lesion
  6. perineural invasion

Diagnosis

  • Nasopharyngeal cancer
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6
Q

Supraglottic cancer

Hx- neck lump

A
  1. Mass in the supraglottic larynx
  2. At the level of the thyroid cartillage
  3. Lymph nodes
    1. Cystic/ enhancing

Differential

  1. Laryngocele

Management

  1. ENT - visualisation
  2. PET
  3. Biopsy
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7
Q

Laryngocele- internal or external

Hx- difficulty swallowing

A
  1. Location-
    1. Arising in supraglottic parapharyngeal space
    2. paraglottic space
    3. communicating with the laryngeal ventricle.
    4. Extralaryngeal extension through the thyrohyoid membrane is seen
  2. Borders
    1. well defined
    2. dumbell shaped
  3. Contrast
  4. Nodes

Diagnosis

  • Laryngocele

Mangement

1) ENT- exclude tumour and primary mass

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8
Q

Acute tendinitis of longus colli

Hx- Patient is well

A

Plain film-

  1. Thickening of retropharyngeal soft tissues.

Impression- abscess

CT neck

  1. Low attenuation in retropharyngeal space
  2. Longus colli calcification
  3. Non-enhancing
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9
Q

Fungal sinusitis

Hx- Diabetic , unwell

A

CT

  1. Mass in the sinuses
  2. Bone erosions
  3. loss of adjacent fat planes

MRI sinuses

  1. T2 low signal
  2. ? invasion of cavernous sinus
  3. ? intracranial abscess
  4. ? venous sinus thrombosis

Invasive

  • Erodes bone
  • retro-antral fat stranding

Allergic

  • No soft tisse
  • No bone reaction
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10
Q

Sick patient and skull base abnormality

A
  1. Coalescent mastoiditis
    1. Destroys mastoid
    2. venous sinus thrombosis
    3. Intra-cranial abscess
  2. Petrouos apicitis
    1. Gradenigo syndrome
      1. Extremely unwell
      2. discharge from ear
    2. Facial pain
    3. Deep skull pain
  3. Malignant otitis externa
    1. Look at skull base

Approach

  1. Non-fat sat T1
    1. Look for loss of marrow signal in bone
  2. T2
  3. Post Gad
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11
Q

Dysphagia

lower cranial nerve palsies on examination

10 and 12

A
  1. CT
    • Bone windows
      • low density mass filling jugular bulb and foramen
      • margin of foramen expanded
  2. MRI
    • Well defined mass in upper carotid space
    • expands jugular bulb and foramen
    • displaces ICA anteromedially
    • intermediate T1
    • Heterogenous T2
    • Marked gadolinium enhancement
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12
Q

Juvenile Angiofibroma

18 yr old nose bleeds

A
    • Well defined lobulater mass
    • centred on/ in the pterygomaxillary fissure
    • extends to film nasopharynx and anteriorly .
  • MRI
    • T1- Hypo
    • T2- hyper
    • enahcned avidly
    • Flow voids,
  • Arises off internal maxillary artery
  • Preoperative diagnositic angiogram and embolisation prior to surgery.
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13
Q

Jaw cyst

A
  1. Dentigerous cyst-
    • crown points to cyst
  2. Amelobastoma-
    • 30-50yrs
    • mandible
    • expansile
    • bubbly
    • “soap bubble”
    • unerupted molar
    • thin cortex
    • soft tissue enhancement
  3. OKC-
    • multiloculated
    • 3rd molar
    • long axis of mandible
    • sclerotic rim
    • gorlin goltz- cutanous basal cell carcinoma
  4. Aneurysmal bone cyst-
    • < 20 yr
    • soap bubble,
  5. Periapical cyst-
    • unilocular
    • root of tooth
  6. Fibrous dysplasia- ‘ground glass matrix’
  7. Mets
  8. myeloma
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14
Q

Inverted papilloma

A
  • well defined
  • low atteunuating mass/ soft tissue density
  • maxillary sinus
  • extends through the maxillary wall and maxillary ostium
  • Can degenerate into nasopharyngeal cancer
  • DD-
    • antrochoanal polyp
    • sinonasal tumour
    • inverted papilloma
    • fungal polyp
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15
Q

Enlarged vestibular aqueduct syndrome

Hx- Bilateral hearing loss inn an 18yr old

A
  • Dilated vesicular aqueduct with dysplasia of cochlea with similar apperance bilaterally
  • IF normal temporal bone
  • review areas- vestibular aqueduct ( normally smallr than adjacent semicercular canal), otosclerosis,
  • Can be either cochlea or semicircular
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16
Q

Cholesteatoma

A
  • erodes scutum
  • erodes
    • ossicles
    • facial nerve canal
    • bone overlying the lateral semicircular canal
    • tegmen tympani
  • MRI
    • bright T2
    • ISo T1
    • does not enhance
    • restricts
  • Look for labryntine fistula
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17
Q

Glomus tympanicum

Hx- pulsatile tinnitus

A
  • Location
    • Mesotympanum, overlying basal turn of the cochlea,
  • No bone erosions
  • avid contrat enhancement
  • In view of pulsatile tinus
  • DD
    • glomus tympanicum
    • glomus jugulare
  • LOOK FOR ANOTHER-
    • Jugular fossa
    • glomus vagale( posterior to carotid sheath)
    • carotid body
    • contralateral neck and look for one in ipsilateral neck
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18
Q

Petrous mass

Carotid aneurysm

Hx- incidental finding

A
  • Location
    • Petrous apex
    • adjacent to carotid canal
    • erodes the carotid canal
  • Description
    • Well defined
    • expansile
    • low attenuating lesion
  • DD
    • choelsterol granuloma
    • cholesteatoma
    • However breach of margin raises suspicion of carotid aneurysm
  • Manage by restricted diffusion and T1 imaging ( cholesterol is really bright, cholesteatoma is not so bright)
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19
Q

Fossa of rosenmuller mass

Hx- blood stained sputum

A
  • Location
  • Enhancing mass in gossa of rosenmuller on left hand side
  • enquire age of patiet
  • mass in close relation to pterygoid bones? erosion
  • LYMPH NODES
    • Level- ? ipislateral / contralateral
  • -LOOK FOR
    • lateral retropharyngeal nodes- reduces survival by 50 %
    • LOOK FOR -
      • synchronous lesion
      • perinueral spread,
  • DD- lymphoma, metastasitic, papillary thryoid cancer
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20
Q
A
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21
Q
A
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22
Q

Orbital mass

A
  1. Haemangioma
    1. intraconal and retrobulbar
  2. Lymphangioma
    1. Normally extraconal compartment
    2. can invade any compartment
  3. Meningioma
    1. “tram track”
  4. Mets
  5. Lymphoma
    1. Lacrimal gland and superior orbit
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23
Q

Cavernous sinus mass

A
  1. Meningioma
    • Stenosis of ipsilateral artery
    • Dural tail
  2. Schwannoma
    • Trigeminal- extend into meckels cave
    • Erosions
  3. Carotid cavernous fistula
  4. Tolosa hunt
    • Orbital pseudotumor
  5. sarcoidosis
    • Smooth or nodular enhancement is seen along the course of the cranial nerves, along with dural or leptomeningeal enhancement
  6. Perineural tumour spread
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24
Q

Aggresive sinus diease with bony destruction

A
  1. Invasive fungal sinusitis
    • Calcifications are common.
    • Hypointensity on both T1 and T2 (more so on T2)
  2. Wegeners granulomatosis
  3. Sinonasal carcinoma
  4. Lymphoma
    • lymphadenopathy within the neck
    • Waldeyer tonsillar ring
  5. Cocaine nose
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25
Q

Unilateral parotid mass

A
  1. Pleomorpic adenoma
    • bright on T2
  2. Warthin
    • mixed cystic and solid
    • occur in middle-aged men
    • bilateral
      • solid portions are generally hypointense on T1- and intermediate in signal on T2-weighted sequences
      • cystic components are hypointense on T1 and hyperintense on T2 sequences
  3. Parodid Ca-
    1. Mucoepidermoid
    2. Adenoid cystic
      1. ill-defined infiltrative appearance with intermediate density and T1/T2 signal intensity
  4. Branchial cleft type 1
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26
Q

Bilateral parotid masses

A
  1. Lymphoepithelial lesion
    • bilateral cystic and solid parotid lesions with di̥ use gland enlargement
  2. Sjogrens
    • heterogeneous glandular enlargement with scattered enhancing nodules and fluid pockets.
  3. Warthins
    1. MRI, the solid portions are generally hypointense on T1-weighted and intermediate in signal on T2-weighted sequences; the cystic components are hypointense on T1 and hyperintense on T2 sequences.
  4. Lymphadenopathy
  5. Sarcoidosis
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27
Q

Orbital muscle involvement

A
  1. Throid
  2. Pseudotumour
    • Involves myotendinous junctions
  3. Lymphoma
  4. Infectious myositis
  5. Sarcoidosis
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28
Q

Pharyngeal mucosal mass

A
  1. SCC
    • fossa of Rosenmüller and may obstruct the eustachian tube.
  2. Lymphoma’
    • Non-necrotic lymph nodes
  3. Infection
    • Striated tonsillar enhancement is seen with tonsillitis
    • abscesses show rim enhancement.
  4. Minor salivary gland
  5. Thornwaldt cyst
    • Hyperintense on both T1- and T2
29
Q

Masticator mass

A
  1. Infection
  2. abscess
  3. Sarcoma
  4. Venolymphatic malformation
    • involve multiple compartment
  5. Nerve sheath tumour
    • neurofibromas and schwannomas
    • occur along the mandibular division of cranial nerve V.
30
Q

Carotid space mass

A
  1. Paraganglioma
    • “salt and pepper” appearance
    • avidly enhance.
  2. Nerve sheath tumour
    • along the course of the vagus nerve
  3. Vascular abnormality
  4. Lymphadenopathy
    • Squamous cell carcinoma
    • Lymphoma
31
Q

Retropharyngeal mass

A
  1. Infection
  2. Nodal mets
    1. SCC is the most common cause of retropharyngeal nodal metastases
    2. followed by papillary thyroid cancer
  3. Lymphoma
  4. Venolymphatic malformation
  5. Plasmacytoma
32
Q

Clival mass

A
  1. Chordoma
  2. Metastatic disease
    • breast
    • lung
    • prostate
  3. Chondrosarcoma
    • arcs and swirls” calcifi cations and bright T2 signal
  4. Invasive pituitary macroadenoma
  5. Plasmacytoma
33
Q

Vascular injury to neck

A
  1. Dissection
  2. Pseudoaneurysm
  3. AV fistula
  4. Thrombosis
34
Q

Persistned globe lesion in a child

A
  1. Retinoblastoma
  2. PHPV
    • microphthalmia
  3. Coats
    • retinal detachment and lack of calcifi cation with a normal globe size
  4. Toxoplasmosis
35
Q

Optic nerve enhancement

A
  1. Optic nerve glioma
    • buckling
    • “dotted i ”
    • Enlargement of optic canal
  2. Optic neuritis
    • enlargement and enhancement of the ḁffected optic nerve.
  3. Optic nerve sheath meningioma
    • Tram track
  4. Leukaemia
  5. Sarcoidosis
36
Q

Pachymeningeal enhancement

A
  1. Intracranial hypotension
    • dural enhancement
    • tonsillar ectopia
  2. Mets
    • Breast
    • lung
    • prostate
    • Lymphoma
  3. Pachymeningitis
  4. Subdural haemorrhage
  5. Sarcoidosis
    • Nodular meningeal enhancement
37
Q

Middle ear mass

A
  1. Cholesteatoma
    1. Acquired cholesteatomas occur in Prussak space and cause blunting of the scutum and ossicular erosion
  2. Facial nerve schwanomma
    • tympanic segment within the middle ear
      • post con- enhancement of labyrinthine segment
  3. Glomus tympanicum
    • cochlear promontory
  4. Cholesterol granuloma
38
Q

Inner ear congenital malformation

A
  1. Large vestibular aqueduct syndrome
    • >1.5 mm in diameter
    • hearing loss is bilateral and progressive
  2. Cystic cochleovestibular anomaly
    • “figure 8
  3. Cystic common cavity
  4. cochlear aplasia
  5. labyrtinthine ossification
39
Q

Floor of mouth mass

Mylohyoid

A
  1. SCC
  2. Infection
  3. Ranula
    • extend below the mylohyoid muscle into the submandibular space- diving ranula
  4. Venolymphatic malformation
  5. Dermoid/ epidermoid
40
Q

Aggresive nasal mass in a child

A
  1. Juvenile angiofibroma
    • Adjacent to the sphenopalatine foramen and near the pterygopalatine fossa
  2. Enthesioneuroblastoma
    • Intracranial extension through the cribriform plate is common.
    • The classic finding is a “dumbbell-shaped” mass in the nasal cavity
  3. Haemangioma
  4. Rhabdomyosarcoma
  5. inverted papilloma
  6. Polyps
41
Q

Cystic neck mass

A
  1. Congenital cyst
    1. Brancial 1- external auditory canal to the angle of the mandible
    2. Branchial 2- angle of the mandible
    3. Type 3 and 4- sinus formation
  2. Abscess
  3. Necrotic lymph node
    • SCC
    • Papillary thyroid
  4. Venolymphatic malformation
42
Q

Jugular foramen mass

A
  1. Paraganglioma
    • “salt and pepper” appearance
    • characterized by multiple flow voids.
    • isointense on T1
    • iso- to hyperintense on T2 sequences.
    • The infiltrative osseous pattern
  2. schwannoma
    1. hypointense on T1 and hyperintense on T2 with respect to brain parenchyma
  3. meningioma
  4. metastatic
    • Breast, lung, and prostate
  5. dehiscent jugular bulb
43
Q

Petrous apex mass

A
  1. Cholesterol granuloma
    • bright on T1- and T2-weighted images.
  2. Mucocele
  3. Cholesteatoma
  4. Apical petrositis
    • Patient is unwell
    • Gradenigo syndrome (apical petrositis, retro-orbital pain, and CN VI defi cits)
  5. Neoplasm
44
Q

Leptomeningeal enhancement

A
  1. Leptomeningeal carcinomatosis
    • Lung
    • Breast
  2. Meningitis
  3. Neurosarcoidosis
  4. Subacute infarction
  5. Subarachnoid haemorrhage.
45
Q

Confluent white matter lesion

A
  1. Demyelinating disease
    • MS
  2. Neoplasm
    • Gliomatosis cerebri
    • lymphoma
    • Infiltrating primary
  3. PML
    • involvement of the subcortical U fibers
  4. Microvascular ischaemic disease
46
Q

Confluent white matter lesions in a child

A
  1. ADEM
    • Monophasic
  2. MS
  3. dysmyelinating
    • Adrenoleukodystophy
  4. PML
47
Q

Ring enhancing lesion

A
  1. Abscess
  2. Neoplasm
    1. GBM
    2. MET
    3. Lymphoma
  3. Demyelinating
  4. Sub-acute infract
  5. contusion
48
Q

Pineal mass

A
  1. Pineal cyst
  2. Germ cell tumour
    • CSF dissemination.
  3. pineal tumour
    1. Pineoblastoma
      • CSF dissemination.
    2. pineocytoma
  4. Meningioma
  5. Tectal plate glioma
49
Q

Suprasellar mass in a child

A
  1. Craniophyarngioma
  2. Germ cell tumour
  3. Rathke cleft cyst
  4. Glioma
    1. Hypothalmic
    2. optic
  5. Hypothalmic hamartoma
50
Q

Posterior fossa mass in a child

A
  1. Medulloblastoma
  2. Ependymoma
  3. Juvenile pilocytic astrocytoma
  4. Brainstem glioma
51
Q

Posterior fossa mass in an adult

A
  1. Met
  2. Haemangioblastoma
  3. Vascular malformation
  4. Hypertensive haemorrhage
52
Q

Posterior fossa cyst

A
  1. Mega cisterna magna
    • normalsized posterior fossa \
    • normal cerebellar vermis
  2. Arachnoid cyst
  3. Dandy-walker malformation
    • vermian aplasia or hypoplasia (Dandy–Walker variant).
53
Q

Tonsillar herniation

A
  1. Chiari 1
    • “peg-shaped” tonsils
    • hydrosyringomyelia
    • beaked tectum
    • cervicomedullary kinking
    • towering” cerebellum
    • dysgenesis of the corpus callosum in 90%
  2. Ependymoma
  3. Intracranial hypotension
54
Q

Enhancing intramedullary mass

A
  1. Ependymoma
    • usually spans three or four vertebral segments
    • Cord edema and syrinx
    • scalloping
  2. Astrocytoma
    • cervical followed by the thoracic spine
    • four vertebral segments
    • Fusiform expansion of the cord
  3. Hemangioblastoma
    • isointense on T1
    • hyperintense on T2 sequences with surrounding cord edema
  4. Metastatic disease
    1. breast carcinoma
    2. melanoma
    3. lymphoma
    4. renal cell
      • nidus of enhancement and extensive edema
  5. Demyelinating disease
    • posterolateral cervical cord
    • flameshaped and T2 hyperintense with little cord swelling or edema
55
Q

Intradural extramedullary mass

A
  1. Nerve sheath tumour
    1. Schwannoma
      • posterior scalloping
    2. Neurofibroma
      • Target sign
  2. meningioma
  3. CSF metastatic disease
    1. anaplastic astrocytoma
    2. glioblastoma multiforme
    3. medulloblastoma
    4. ependymoma
    5. choroid plexus tumor
    6. germinoma
56
Q

Temporal lobe mass

A
  1. HSV
    1. Bilateral, asymmetric involvement is common
    2. basal ganglia are spared
    3. cortical and subcortical edema with loss of the gray-white junction and local mass e̥ffect
    4. T2 hyperintense subacute hemorrhage and restricted di̥ffusion
  2. Ischaemia/ infarction
  3. Gliomatosis cerebri
  4. Limbic encephalitis
    1. primary malignancy
      1. lung
      2. breast
  5. Status epilepticus
57
Q

Increased T2 in basal ganglia in a child

A
  1. Ischaemia
  2. Metabolic
    1. Wilsons
      • “face of the giant panda” sign on axial T2 images
    2. Mitochondrial
      1. MELAS
        • ischemic fi ndings in nonvascular distributions
      2. Leigh
        • bilateral symmetric basal ganglia T2/FLAIR hyperintensities.
  3. Toxins
    1. Carbon monoxide
      • T2 hyperintensity (T1 hypointensity) of globus pallidi
  4. Extra-pontine demyelination
58
Q

Intraparenchymal haemorrhage

A
  1. Vascular malformation
  2. Haemorrhaging infarct
  3. Haemorrhagic neoplasm
  4. Contusion
  5. Cerebral amyloid
59
Q

Corpus callosal mass

A
  1. Glioblastoma multiforme
  2. Lymphoma
  3. Demyelination
  4. DAI
  5. Machiafava bignami
60
Q

Sub ependymal nodules

A
  1. Sub-spendymal hamartomas
  2. heterotopic grey matter
  3. TORCH
    1. CMV
    • subependymal and periventricular calcifications
  4. Metastic disease
61
Q

Massive supratentorial CSF collection in a newborn

A
  1. Hydrocephalus
    • thin mantle of cortex
    • presence of the falx
  2. Hydranecephaly
    • Intact posterior fossa structures,
    • absence of a cortical mantle around a large supratentorial CSF-fi lled cavity.
  3. Holoprosencephaly
    1. Absent
      • corpus callosum
      • anterior falx
      • interhemispheric fissure
      • sylvian fissures are absent.
  4. Agenesis of corpus callosum
    • Interhemipsheric cyst
  5. Bilateral open lip schizencephaly
62
Q

Intraventricular mass

A
  1. Meningioma
    • trigone
  2. Choroid plexus papilloma
  3. Central neurocytoma
    • attached to the septum
    • “bubbly”
    • circumscribed and lobulated
    • Calcification and flow voids
  4. Ependymoma/ Sub-spendymoma
    • fourth ventricle
  5. SEGA
  6. Colloid cyst
63
Q

Cerebellar atrophy

A
  1. Alcohol
  2. Anti-convulsants
  3. Paraneoplastic
    • breast, lung
  4. Sporadic olivopontocerebellar
  5. Freidreichs ataxia
    • atrophy of the vermian and paravermian structures
    • small medulla oblongata
    • significant atrophy of the spinal cord
64
Q

Spinal cord abnormality

A
  1. Demyelinating disease
    • posterolateral aspect of cord
    • little edema
  2. contusion
    • increased T2 signal intensity and edema
    • spine fractures
    • marrow edema
    • ligamentous injury
    • soft tissue injuries
  3. Intramedullary neoplasm
  • ependymomas
    • circumscribed and heterogeneous; intratumoral cysts and cord edema are commonly seen.
  • Astrocytomas
    • ill-defined
    • di̥ffuse
    • fusiform expansion of the cord
  1. Transverse myelitis
    • ventral and dorsal cord
  2. cord ischaemia
    1. central gray matter
65
Q

Cortical based neoplasm

A
  1. Oligodendroglioma
    • cortical expansion
    • Calcification
    • Cystic degeneration
    • Heterogeneous enhance
    • remodeling or erosion of the overlying calvarium.
  2. Astrocytoma
    • circumscribed
    • minimal or no edema
  3. PXA
    • Temporal lobe
      • cystic lesions
      • enhancing mural nodule
      • abuts meninges with a dural tail.
  4. ganglioglioma
    • well-circumscribed cystic mass
      • mural nodule
    • solid tumor that expands the cortical gyri.
    • Calcifications and enhancement may be seen in ~50%
  5. DNET
    • wedge-shaped
    • multinodular
    • pseudocystic cortical mass
    • scalloping of the overlying calvarium
  6. Desmoplastic infantile glioma
66
Q

Epidural spinal mass

A
  1. Disc extrusion
    • extruded fragment is usually similar in signal to the parent disc
    • peripheral enhancement
  2. Epidural haematoma
    • dorsal
    • biconvex and surrounded by epidural fat
    • Peripheral enhancement is common
  3. Epidural abscess
    • fluid signal with peripheral rim
    • adjacent dural enhancement.
  4. Synovial cyst
  5. Metastatic disease
    • T1 hypointense and T2 hyperintense with di̥ffuse or heterogeneous enhancement
  6. Epidrual lipomatosis
67
Q

Prominent perivascular cystic lesions

A
  1. Virchow robinsons spaces
    • basal ganglia
    • anterior commissure
  2. Lacunar infarctions
  3. Infection
    1. cryptococcus
      • simulate VR spaces or lacunar infarcts
    2. neurocystirecocosis
  4. cystic neoplasm
  5. nueroglial cyst
68
Q

Intracranial hypotension

A
  1. Bilateral subdural haematomas/ hygromas
  2. Diffuse pachymeningeal enhancement
  3. Volume change
    1. Slumped midbrain
    2. Effaced pre-ponitine and suprasellar cistern
    3. Low lying tonsils
  4. Engorged venous sinuses

Ask- Is there CN6 nerve involvement

DD-

  1. Intracranial hypotension
  2. Meningitis
    3.
69
Q

Intracranial hypertension

A

3 differentials (8 decks)

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