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Neuroradiology > Neuro Buzz > Flashcards

Neuro Buzz Flashcards

1
Q

Le Fort 1

A

The palate is separated from the maxilla
Lateral nasal aperture

Floating palate

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2
Q

Floating palate

? Which type of Le Fort?

A

Type 1

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3
Q

Le Fort type 2

A

The maxilla is separated from the face
Inferior orbital rim and orbital floor

Pyramidal

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4
Q

Pyramidal

What type of Le Fort fracture?

A

Type 2

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5
Q

Le Fort type 3

A

The face is separated from the cranium

The zygomatic arch and lateral orbital rim/wall

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6
Q

If …. is not fractured then you don’t have a Le Fort fracture

A

Pterygoid process

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7
Q

Airless expanded sinuses

A

Mucocele

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8
Q

Most sensitive MRI sequence for SAH

A

FLAIR

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9
Q

The classic history for superficial siderosis

A

Sensorineural hearing loss and ataxia

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10
Q

Watershed infarct in a kid

A

Moyamoya

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11
Q

What is a pedicle aneurysm?

A

Artery feeding AVM

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12
Q

This type of aneurism is seen in patients with PAN, Ct disease and syphylis

A

Fusiform aneurysm

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13
Q

Pulsatile tinnitus is seen in ….

A

Sigmoid sinus thrombosis

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14
Q

Visual problem is caused by thrombosis in this venous structure

A

Cavernous sinus

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15
Q

Most common type of AVF’s- gradual onset LE weakness

A

Spinal AVF

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16
Q

This venous anomaly looks like a large tree with multiple small branches/ caput medusa.
It is also associated with cavernous malformation

A

DVA

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17
Q

Slow flow lesion with dilated capillary bed without intervening normal brain tissue

Popcorn like with peripheral rim of haemosiderin

A

Cavernous malformation

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18
Q

Slow flow lesion with normal intervening brain tissue. They have brush like or stippled appearance of enhancement

A

Capillary telangectasia

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19
Q

This malformation can be seen as a complete location of radiation therapy

A

Capillary telangectasia

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20
Q

Define colpocephaly

A

This is asymmetric dilation of the occipital horns

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21
Q

Name two causes of colpocephaly

A

CC a genesis and pericallosal lipoma

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22
Q

Which type of CNS lipoma usually calcify?

A

The tubulonodular type

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23
Q

Define anencephaly

A

Neural tube failing to close on the cranial end leading to reduced or absent cerebrum and cerebellum. The hindbrain will be present

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24
Q

In this condition the AFP will be elevated and there will be polyhydramnios

Frog eye appearance

A

Anencephaly

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25
Q

What is iniencephaly

A

This is when the occipital bone is missing and there will be an enlarged foramen magnum

Star gazing fetus

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26
Q

What is rhombencephalosynapsis

A

Congenital anomaly of the cerebellum where the vermis does not develop and the cerebellum is fused

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27
Q

What is Joubert syndrome associated with?

A

Retinal dysplasia

Multicystic dusplastic kidney

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28
Q

Molar tooth appearance- small or aplastic vermis and absence of pyramidal decussation

A

Joubert syndrome

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29
Q

Joubert syndrome and liver fibrosis

A

Coach syndrome

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30
Q

Absent vermis

Torcular lambdoid inversion

A

Dandy Walker

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31
Q

Holoprosencephaly- HP

A

This is a midline cleaving problem with brain failing to cleave into two separate hemisphere

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32
Q

The olfactory bulb is affected in this type of HPE

A

Semi lobar

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33
Q

HPE association (3)

A
  • single midline monster eye
  • solitary median maxillary incisor- MEGA INCISOR
  • Nasal process overgrowth leading to pyriform aperture stenosis
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34
Q

What is meckel gruber syndrome

A

Classic triad of

HPE

Multiple renal cysts

Polydactyly

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35
Q

Hemimegalencephaly

A

Big brain with big ventricles

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36
Q

Types of lissencephaly pachygyria

A

Type 1- classic form - smooth brain due to arrest of migration

Type 2- cobblestone brain due to over migration. The cortex is thinner than type 1. No band heterotopia.

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37
Q

This type of lissencephaly is associated with band heterotopia. It’s a figure 8, hour glass configuration with shallow sylvian fissure

A

Type 1/ classic lissencephaly

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38
Q

What conditions are associated with schizencephaly

A

Optic nerve hypoplasia 30%
Absent septum pellucidum 70%
Epilepsy 50-80%

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39
Q

What is hydranencephaly?

A

Destruction of cerebral hemispheres. Bag of CSF. Secondary to vascular insult e.g. Double mca infarct.

Can also be caused by TORCH- HSV

Normal falx but the cortical mantle is gone.

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40
Q

Define type 1 chiari

A

One cerebellar tonsil more than 5 mm below the foramen magnum. Look for syringohydromyelia

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41
Q

What is chiari 1 associated with?

A

Klipple feil syndrome

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42
Q

name some of the findings of chiari 2

A 
Hydrocephalus 
Myelomeningocele
Towering cerebellum
Tectal plate beaking 
Long skinny 4th ventricle- normal 4th ventricle ? Shunt  malfunction 
Interdigitated cerebral gyri
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43
Q

Scaphocephaly

Which suture?

Also known as ?

A

This is premature fusion of Sagittal suture

Also known as dolichocephaly

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44
Q

Brachycephaly

A

Premature fusion of Coronal and / or lambdoid and is often associated with syndromes

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45
Q

Brachycephaly and fused fingers

A

Aperts

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46
Q

Brachycephaly and first arch ( maxilla and mandible hypoplasia

A

Crouzons

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47
Q

Brachycephaly and Wormian bone and absent clavicle

A

Cleidocranial dysostosis

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48
Q

BESSI vs Subdural collection (1)

A

BESSI - cortical veins are adjacent to inner table

Subdural- cortical veins are displaced away from the inner table

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49
Q

Diagnosis?

Failure to get ass an NGT in a child or respiratory distress while feeding

A

Choanal atresia

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50
Q

Name 5 syndromes associated with choanal atresia

A
  1. CHARGE
  2. Crouzons
  3. DiGeorge
  4. Treacher Colins
  5. Fetal alcohol syndrome
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51
Q

The piriform aperture stenosis is highly associated with …

A

Hypothalamic pituitary adrenal axis dysfunction

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52
Q

Diagnosis?

Mitochondrial disorder with lactic acidosis and stroke like episodes

A

MELAS

53
Q

What are the spect findings in MELAS

A

Increased lactate and decreased NAA

54
Q

Name the leukodystrophies:

Shown with SPECT WITH ELEVATED NAA

A

Canavans

55
Q

Name the leukodystrophies:

big head with frontal lobe white matter involvement

A

Alexanders

Big head like Alexander the Great

56
Q

Name the leukodystrophies:

Tigroid- dark spots or stripes within the T2 bright demyelinated periventricular wm

Deficiency of enzyme arylsulfatase A

A

Metachromatic

57
Q

Name the leukodystrophies:

Normal head with symmetric occipital and splenium of cc white matter involvement

It is sex linked and only occurs in boys

A

Adreno leukodystrophy

58
Q

Name the leukodystrophies:

Normal head
Focal areas of subcortical wm. BG and the periaquaductal GM have involvement

A

Leigh disease

Also called subacute necrotising encephalomyelopathy

Mitochondrial enzyme defect

59
Q

The NAA and s super high in this disease

A

Canavans

60
Q

Name three reasons for raised choline

A

Increased choline in increased cell turn over:

Malignancy

Infarct

Inflammation

61
Q

There is usually no peak for lactate. If there is then it means …… and ….

A

Necrotic tumour
And
Infection - abscess

62
Q

What is raised in hepatic encephalopathy

A

Glutamine

63
Q

What is raised in meningioma

A

Alanin

NAA is not raised

64
Q

Myoinositol is raised in which 2 conditions?

A

Alzheimer’s and low grade glioma

65
Q

MRS pattern in

High grade tumour

A

Choline raised
Lactate and lipid raised

NAA reduced

66
Q

MRS pattern in

Low grade tumour

A

Choline and NAA reduced

Inositol raised

67
Q

MRS pattern in

Radiation necrosis

A

Choline and NAA reduced

Lactate increased

68
Q

This lesion is the primary petrous apex lesion. It’s T1 and T2 bright with T2 dark hemosiderin rim

A

Cholesterol granuloma

69
Q

Lesion in petrous apex
T1 dark
T2 bright
With restricted diffusion

A

Cholesteatoma

70
Q

Difference between cholesteatoma and cholesterol granuloma

A

Granuloma: T1 and T2 bright. Does not restrict. Smooth expansile bone changes.

Cholesteatoma: T1 dark, T2 bright with restricted diffusion. Smooth expansile bone changes.

71
Q

Classic triad for grandenigo syndrome

A

Otomastoiditis

Face pain- trigeminal neuropathy

Lateral rectus palsy

72
Q

Endolymphatic sac tumour is associated with

A

VHL

73
Q

Appearances of endolymphatic sac tumour

A

They grow into CPA
Internal amorphous ca++ on CT
T2 bright with intense enhancement
Very vascular with flow void and tumour blush on angio

74
Q

Patient presents with hoarseness

MRI: hypervascula lesion, salt and pepper on post contrast MRI with flow void

FDG avid

A

Paraganglioma

75
Q

Imaging findings in labyrinthitis

A

The cochlea and semicircular canals will be enhancing on T1 post contrast images.

76
Q

Conductive hearing loss in adult female

A

Otosclerosis

77
Q

Types of otosclerosis (2)

A

Fenestral

Retro fenestral

78
Q

Cholesteatoma order of destruction predictable

A

Scutum is eroded early
The ossicles- long process of incus
The lateral segment of the semi circular canal

Fistula to the semi circular canal most commonly involves the lateral segment

79
Q

In labyrinthine fistula, which part is most commonly affected?

A

The lateral semicircular canal is most often involved

80
Q

Noise induced vertigo

A

Superior semicircular canal dehiscence

81
Q

Necrotising external otitis

Predisposing disease
Causative agent

A

95% have diabetes and the causative agent is 98% pseudomonas

82
Q

Which part of the facial nerve does not enhance?

A

The cisternal , canalicular and labyrinthine segments should not enhance

The normal enhancement is due to perineural venous plexus

83
Q

What causes abnormal enhancement of the facial nerve? (4)

A

Bell’s palsy
Lymes
Ramsay Hunt
Cancer

84
Q

Ground glass lesion in a young patient

A

Fibrous dysplasia

It usually spares the optic capsule

85
Q

Multi focal fibrous dysplasia, cafe au lair spots and precocious puberty

A

Mc Cune Albright syndrome

86
Q

Mouth mass lesion in the midline. It’s fluid sack with globules of fat- sack of marbles.

A

Floor of mouth dermoid/ epidermoid

87
Q

What is a ranula?

A

This is a mucous retention cyst- typically lateral

88
Q

Where would ranula arise from?

A

Arise from sublingual gland/ space

Once it’s under the mylohyoid muscle it’s plunging

89
Q

Diagnosis?

Grandmothers dentures won’t stay in

A

Torus palatinus- bony exostosis that comes off the hard palate in the midline

90
Q

Re sialolithiasis , which gland is most commonly affected?

A

Submandibular gland duct- whartons

91
Q

Diagnosis?

Young patient with new level II neck mass

A

HPV related SCC

92
Q

Aetiology of osteonecrosis of the mandible (2)

A

Prior radiation

Bisphosphonate treatment

93
Q

Microcalcification is seen in thyroid mass. Diagnosis?

A

Papillary thyroid cancer

94
Q

Come tail in thyroid nodule means…. nodule.

A

Colloid nodules

95
Q

This condition increased your risk of primary thyroid lymphoma

A

Hashimotos

96
Q

Hashimotos is associated with which auto antibodies

A

Thyroid peroxidase TPO and anti thyroidglobulin

97
Q

Name two findings associated with hashimotos on uss

A

White knight- uniform hyperechoic nodules

Giraffe skin- heterogenous appearances

98
Q

A sick looking level 6 node or delphian node is a sign of ….

A

Laryngeal cancer met

99
Q

What are the causes of hyper PTH? (3)

A
  1. Hyper functioning adenoma
  2. Multi gland hyperplasia
  3. Cancer
100
Q

What factors does sestamibi parathyroid imaging depend on?

A

Mitochondrial density and blood flow

101
Q

This type of thyroid cancer is asso with MEN 2 They produce calcitonin

A

Medullary type

102
Q

This type of thyroid cancer is seen in elderly patients with prior radiation treatment

A

Anaplastic type

103
Q

What is the best way to monitor the Hurthle cell follicular cancer?

A

FDG PET

104
Q

What’s contained in the parotid space (3)

A
  1. parotid gland
  2. Facial nerve
  3. Retro- mandibular vein
105
Q

This is the only salivary gland containing lymph nodes

A

Parotid gland

can get lymphoma therefore.

106
Q

Diagnosis?

male smoker presenting with bilateral cystic mass in parotid gland

A

Warthins

107
Q

How do you diagnose warthins?

A

it takes up pertechnetate

the only super rare tumour to take this up is parotid oncocytoma

108
Q

this salivary gland tumour likes perineurial spreads

A

adenoid cystic carcinoma

109
Q

This group of patients have high risk of getting bilateral lymphoma in parotid gland

A

Sjogren

110
Q

Diagnosis?

HIV patient with painless bilateral mixed solid and cystic lesions with enlarged parotid glands

A

Benign lymphoepithelial disease.

111
Q

Diagnosis?

female in their 60’s present with dry eyes and mouth. The parotid gland has honeycomb appearance

A

Sjogrens

112
Q

Which type of lymphoma would patients with Sjogren’s get?

A

non hodgkins MALT type lymphoma.

113
Q

What is contained in the carotid space? (4)

A
  1. Carotid artery
  2. Jugular vein
  3. Cranial nerves 9, 10 and 11
  4. internal jugular chain lymph nodes
114
Q

Name the different types of tumours arising from the carotid space (3)

A
  1. Schwannoma
  2. Paraganglioma
  3. Neurofibroma
115
Q

compare the schwannomas and paraganglioma (4)

A 
Paraganglioma:
Flow void 
Hypervascular
In 111 octreotide avid
Salt and pepper look on MRI
Schwannomas
Not all are hyper vascular
No flow void - target sign
NOT IN111 Octreotide avid
No salt or pepper
116
Q

What is Lemierre disease?

A

Thrombophlebitis (thrombosis) of the jugular vein with distant metastatic sepsis- usu septic emboli in lung. It is usually found in the setting of oropharyngeal infection or recent ENT surgery
BUZZ: Fusobacterium Necrophorum

117
Q

When i say perineurial spread, you should think: (2)

A
  1. adenoid cystic salivary tumour

2. melanoma

118
Q

This tumour causes neural foramina expansion

A

Schwannoma

119
Q

What is Grisel’s syndrome?

A

Torticollis with atlantoaxial joint inflammation seen in H&N surgery or retropharyngeal abscess

120
Q

what is contained within the parapharyngeal space?

A

trigeminal nerves and the pterygoid veins

121
Q

Bilateral optic nerve glioma is seen in this condition:

A

NF1

122
Q

Diagnosis?

doughnut appearance with circumferential enhancement around optic nerve. Tram track calcification.

A

Optic nerve sheath meningioma

123
Q

Most common location for orbital dermoid

A

superior and lateral. From frontozygomatic suture

124
Q

DDx for raccoon’s eyes: (2)

A

Met neuroblastoma and skull fracture

125
Q

Orbital lymphoma is associated with these 2 conditions

A

chlamydia Psittaci and MALT lymphoma

126
Q

Diagnosis?

Ca in globe of a child <3 years

A

Retinoblastoma

127
Q

Diagnosis?

Bilateral coloboma is associated with …..

A 
CHARGE syndrome
Coloboma
Heart defect
Atresia choanal
Retardation
Genital hypoplasia 
Ear abnormality- Deaf
128
Q

Small size eyes ddx (3)

A

PHPV
Coats
Retinopathy of prematurity

129
Q

What is type 2 lissencephaly is associated with?

A

Cerebellar and ocular malformation and muscular dystrophy - walker warburg syndrome

Neuroradiology (6 decks)

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