Neuro Flashcards
Difference between dermoid and epidermoid?
Dermoid will often have fat and calcs, be midline. Epidermoid will look like arachnoid cysts except restrict diffusion
What is the most common expansile lesion of the paranasal sinuses?
Mucocele
What is the blood supply of the inferior temporal lobe?
posterior cerebral artery
Location of 1st branchial cleft cyst?
periauricular/ adjacent to parotid gland
Location of 2nd branchial cleft cyst?
pushes submandibular glad anteromedially, carotid space medially, and sternocleidomastoid muscle posterolaterally
Location of 3rd branchial cleft cyst?
rare, posterolateral to carotid space
Location of 4th branchial apparatus sinus tracts?
pyriform sinus to upper left thyroid lobe
Painful scoliosis in 10-30 yo patient- with expansile lytic lesion of the spine.
Osteoblastoma. Osteoid osteoma fits too if lesion is less than 1.5cm.
Chiari 2 malformations are associated with which spinal abnormality?
Open spinal dysraphisms (myelomeningoceles). Close dysraphisms do not cause chiari malformations (lipomyelomeningoceles etc).
What fractures comprise a LeForte type I?
“Floating palate”
horizontal maxillary fracture, separating the teeth from the upper face
fracture line passes through the alveolar ridge, lateral nose and inferior wall of maxillary sinus
What fractures comprise a LeForte type II?
“pyramidal fracture”
pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex
fracture arch passes through posterior alveolar ridge, lateral walls of maxillary sinuses, inferior orbital rim and nasal bones
What fractures comprise a LeForte type III?
“Floating face”
craniofacial dysjunction
fracture line passes through nasofrontal suture, maxillo-frontal suture, orbital wall, and zygomatic arch / zygomaticofrontal suture
What fractures comprise a zygomaticomaxillary fracture?
Anterior and posterolateral walls of the maxillary sinus, zygomatic arch, lateral orbital wall
What are the features of hypertrophic cardiomyopathy on MRI?
Asymmetric hypertorphy of the septal portion of the left ventricular wall. Delayed enhancement.
F-18 PET shows hypermetabolism where in Lewy body dz?
Occipital lobe.
What is the anatomic location difference between jugular foramen schwannoma and glomus jugulare?
Jug foramen schan -> superomedial
Glomus jugulare -> superolateral
Unilateral coronal or lamboid suture synostosis will cause what skull shape?
plagiocephaly.
Neuro tumor
young adult
lateral ventricle attached to cavum septi pellucidi
bubbly
minimal enhancement
central neurocytoma
inflammation of lateral rectus muscle
IOID= idiopathic orbital inflammatory disease
ddx: thyroid- prefers medial and inferior rectus m.
lymphoma will have inflammatory changes
What major structure passes through the foramen spinosum?
Middle meningial artery.
This is the high heels “spine/spike”
What passes through the foramen lacerum? And where is it?
irregular opening in central skull base ant/inf to the apex of the petrous temporal bone.
emissary veins pass through it
Esthesioneuroblastoma… what?
- involves both nasal cavity and ant cranial fossa
- makes a figure 8 as it passes through the ant skull base
- highly vascular/avid enhancement
- bone destruction
- cysts at the interface between intracranial tumor spread and the brain parenchyma=characteristic
What the H is the modiolus?
The modiolus is the central bony axis of cochlea that houses the spiral ganglion (cell bodies of cochlear nerve).
Glossopharyngeal nerve exits through which foramen?
Pars nervosa of the jugular foramen.
Which orbital muscles are affected by thyroid opthalmopathy?
“I’M SLO”
inferior
medial
superior
latereral
oblique
Small, mult, bilat cystic lesions of the choroid plexus with restrictued diffusion?
Choroid plexus cysts aka choroid plexus xanthogranulomas
incidental or sometimes HAs
Spine tumor
adult
vascular flow voids
T1 dark/iso and T2 bright
intense enhancement
spinal cord hemangioblastoma
Hosoprosencephaly detected on fetal u/s is related to what genetic abnormality?
trisomy 13
(anterior monoventricle)
MC neuro manifestation of HIV?
HIV enchaphalitis.
- atrophy and bilateral T2 and FLAIR hyperintensity of periventricular white matter and centrum semiovale with no enhancement.
- sparing of subcortical U-fibers distinguishes HIV encephalitis from PML
Spine lesion
popcorn pattern of signal intensity within the cord
cavernous malformation
Cerebral tumor
adult
well-defined
slow growing
cortical/subcortical frontal lobe
hyperintense on FLAIR, no restricted diff
can have calcs, cystic degeneration, hetero enhance
Oligodendroglioma
Cerebral tumor
T1 hyperintense sellar/suprasellar mass with a T2 hypointense nodule
Rathke cleft cyst
most common location for a paranasal sinus mucocele?
Frontal sinus
Name epidemiological difference between ependymoma and subependymoma?
ependymoma is kiddos
subependymoma is older
acute inflammation and demyelination of white matter typically following a recent (1-2 weeks prior) viral infection or vaccination.
Grey matter, especially that of the basal ganglia, is also often involved, albeit to a lesser extent, as is the spinal cord.
ADEM
acute disseminated encphalomyelitis
usually peds
Perimesencephalic nonaneurysmal SAH
pons/midbrain SAH that usually has normal angiogram (source?)
Blood on MRI
I Be: T1 Isointense, T2 Bright, hyperacute < 24 hrs
IdDy: T1 Isointense, T2 Dark, acute 1 to 3 days
BiDy: T1 Bright, T2 Dark, early subacute 2 to 7 days
BaBy: T1 Bright,T2 Bright, late subacute 7 to 14-28 day
Doo Doo: T1 Dark, T2 Dark, chronic > 14 to 28 days
Evil looking level 6 node
Delphian node = laryngeal cancer met
female with painful thyroid gland after URI
subacute thyroiditis/DeQuervains
IgG4 assoc dz of thyroid where thyroid is replaced by fibrous tissue
Reidels Thryoiditis
U/S: decreased vascularity
MRI: dark on all sequences (fibroma)
A kiddo has a 4th bachial cleft anomaly and develops thyroid infxn
Acute suppurative thyroiditis via pyriform fistula
comet artifact in thyroid nodule
colloid
hyperfunctioning nodule on iodine study
thyroid adenoma, will look like colloid nodule on U/S
MC subtype of thyroid cancer?
papillary
good prognosis
responds well to I-131
microcalcs
second MC thyroid cancer
follicular
mets, ok survival
responds to I-131
Thyroid CA in patient with MEN II a and b
Medullary
local invasion
no response to I-131
who gets anaplastic thyroid CA?
elderly, radiation treatment
does not repsond to I-131
Variant of follicular thyroid CA?
Hurthle cell
elderly
worse at I-131 uptake
PET to follow
What is a possible risk of I-131 tx in patient with pulm mets?
pulmonary fibrosis
MC cause of hyperparathyroidism?
parathyroid adenoma
They show you a SPECT with elevated NAA?
Canavans. Its a leukodystrophy.
Think caravans in the desert for salt (NAA??) mines
The other two:
Alexanders- big headed- Alex the great, frontal white whater
Metachromatic- tigroid
Ludwig’s angina
aggressive cellulitis in the floor of the mouth. there will be gas everywhere. usually from odontogenic infection
causes of osteonecrosis of the madible
prior radiation, bisphosphonate treatment
MC tumor of salivary glands?
pleomorphic adenoma (benign mixed tumor).
tx: surg, can become malignant
occur in all salivary glands
which tumor occurs ONLY in parotid?
warthins
smoker, male, cystic, B 15%
can take up pertechnetat (unique)
MC tumor of minor salivary glands?
mucoepidermoid carcinoma
Which malignant tumor can be seen in parotid?
adenoid cystic carcinoma
perineural spread
Devics = ? (aka?)
neuromyelitis optica
subacute combined degeneration = ? (aka)
B12 deficiency
symmetrically increased T2 signal in the doral columns
