LGD2 Neuroradiology

Question 1

52 year old male present to ED after a motor vehicle collision. The patient is difficult to wake and has trouble following commands. An MRI for brain is ordered and shows the following abnormality. Which of the following is most diagnosis?

A.Infection with neurocystercosis
B.Small cavernous malfromations
C.Metatstatic disease
D.Amyloid deposits
E.Diffuse axonal injury

Answer 1

E. diffuse axonal injury

Question 2

An 18 year old male presents to the ED after a skiing accident. He is difficult to arouse and confused. CT scan of the head is performed. Which of the following is the most likely diagnosis?

A. Epidural hematoma

B. Subdural hematoma

C. Subarachnoid hematoma

D. Intraventricular Hematoma

E. Intraparenchymal hematoma

Answer 2

A. epidural hematoma

Question 3

Injury to which of the following vessels is most common cause of epidural hematoma? A. Internal carotid artery B. Middle cerebral artery C. Middle meningeal artery D. Superficial temporal artery E. Superior saggital sinus F. Transverse sinus

Answer 3

C. Middle meningeal artery

Question 5

38 year old female presents to the ED with worst headache of her life. CT scan of the head is obtained and shows a subarachnoid hemorrhage (SAH). Cerebral angiogram is then performed and shown below. What is the etiology of the SAH?

A.Internal carotid artery aneurysm
B.Anterior cerebral artery aneurysm
C.Middle cerebral artery aneurysm
D.Posterior cerebral artery aneurysm
E.Basilar artery aneurysm

Answer 5

C. middle cerebral artery aneurysm

Question 6

73 year old female was found to have new onset left visual loss and progressive weakness of her right arm and leg. CT and MRI of the brain was performed. Which of the following conditions is the most likely cause of the abnormality on CT and MRI?

A.Diabetes Mellitus
B.Atrial fibrillation
C.Hypertension
D.Congestive Heart Failure
E.Deep vein thrombosis
F.Carotid artery stenosis

Answer 6

atrial fibirllation

Question 7

80 year old male with history of MI presents with temporary vision loss in right eye and mild weakness of right leg. MRI of brain shows multiple small infarcts. Which of following most appropriate next step in management

A. carotid doppler

B. cardiac echo

C. BP control

D. MRI with contrast

E. cerebral angiogram

Answer 7

B. cardiac echo

you are looking for process taht goes to both circulations = embolic; must be central; look for clot in the heart itself; if negative –> do carotid doppler in case there is some weird circulation/connection

Question 8

82 year old male presents to ED after seizure. He is found to have a tumor in the left frontal lobe with signficant edema. Which of the following types of herniation is present on this image?

A.Uncal herniation
B.Subfalcine herniation
C.Transcalvarial herniation
D.Traninscisural herniation
E.Tonsillar herniation

Answer 8

B. subfalcine herniation

Question 9

What vessel can get injured in subfalcine herniation?

Answer 9

anterior cerebral artery

Question 11

What kind of herniation do you often get in stroke in MCA territory?

Answer 11

central herniation

Question 12

32 year old female with a prior history of dysphagia, left arm weakness and diplopia lasting 2 weeks now presents with new right hand weakness. Which of the following is the most likely diagnosis?

A.Metastatic disease
B.Stroke
C.Vasculitis
D.Migraines
E.Multiple Sclerosis
F.Traumatic brain injury

Answer 12

E multiple sclerosis

Question 13

45 year old male with AIDS who presents with left sided weakness. He has 2 cats at home. Which of the following opportunistic infections is the most likely cause of the his symptoms?

A.Toxoplasmosis
B.Cryptococcosis
C.JC virus
D.CMV
E.HSV

Answer 13

A. toxoplasmosis

Question 14

8 year old male presents with ataxia, nausea and vomiting. MRI of the brain with contrast is shown. Which of the following is the most likely diagnosis?

A.Metastatic disease
B.Glioblastoma multiforme
C.Lymphoma
D.Pilocytic astrocytoma
E.Meningioma

Answer 14

pilocytic astrocytoma