Neuro CORE - Sheet1 Flashcards
dural ectasia associations
NF-1 and Marfans
fracture plane extending through all 3 vertebral columns
Chance
Contents: foramen ovale
CN V3, accessory meningeal artery
Contents: foramen rotundum
CN V2 (“R2V2”)
Contents: Superior Orbital Fissure
CN 3, CN 4, CN VI, CN6
Contents: Inferior Orbital Fissure
CN V2
Contents: Foramen Spinosum
Middle Meningeal Artery
Contents: Jugular Foramen
Jugular Vein, CN 9, CN 10, CN 11
Contents: Hypoglossal Canal
CN 12
Contents: Optic Canal
CN 2, and Opthalmic Artery
Contents: Foramen Lacerum
emissary veins
MRI signal: HIV encephalitis vs. PML
- HIV Encephalitis is symmetric (T2 bright, Tl normal)
* PML is asymmetric (T2 bright, Tl dark)
Thallium: Toxo vs. lymphoma
Toxo = thallium cold, Lymphoma = thallium hot
Longitudinal vs. transverse t-bone fx: commonest
longitudinal is more common
Longitudinal vs. transverse t-bone fx: associated injuries
long: ossicular dislocation, trans: vascular injury (carotid/jugular)
Longitudinal vs. transverse t-bone fx: facial n. damage
more common in trans
Longitudinal vs. transverse t-bone fx: hearing loss
long: conductive, trans: sensorineural
Tumors! NF-1
Optic Nerve Gliomas
Tumors! NF-2
MSME; Multiple Schwannomas, Meningiomas, Ependymomas
Tumors! VHL
Hemangioblastoma (brain and retina)
Tumors! TS
Subependymal Giant Cell Astrocytoma, Cortical Tubers
Tumors! nevoid basal cell syndrome (gorlin)
Medulloblastoma
Tumors! Turcot
GBM, Medulloblastoma
Tumors! Cowden
Lhermitte-Dulcos (Dysplastic cerebellar gangliocytoma)
Maximum Bleeding - Aneurysm Location: ACOM
Interhemispheric Fissure
Maximum Bleeding - Aneurysm Location: PCOM
Ipsilateral Basal Cistern
Maximum Bleeding - Aneurysm Location: MCA trifurcation
Sylvian Fissure
Maximum Bleeding - Aneurysm Location: basilar tip
Interpeduncular Cistern, or Intraventricular
Maximum Bleeding - Aneurysm Location: PICA
Posterior Fossa or Intraventricular
When I say “cervical kyphosis”, you say
NF- 1
When I say “lateral thoracic meningocele,” you say
NF- 1
When I say “bilateral optic nerve gliomas,” you say
NF-1
When l say “bilateral vestibular schwannoma,” you say
NF-2
When I say “retinal hamartoma,” you say
TS
When I say “retinal angioma,” you say
VHL
When I say “brain tumor with restricted diffusion,” you say
lymphoma
When l say “brain tumor crossing the midline,” you say
GBM (or lymphoma)
When I say “Cyst and Nodule in Child,” you say
Pilocystic Astrocytoma
When I say “Cyst and Nodule in Adult,” you say
Hemangioblastoma
When I say “multiple hemangioblastoma,” you say
Von Hippe! Lindau
When l say “Swiss cheese tumor in ventricle,” you say
central neurocytoma
When I say “CN3 Palsy,” you say
posterior communicating artery aneurysm
When I say “CN6 Palsy,” you say
increased ICP
When I say “Ventricles out of size to atrophy,” you say
NPH
When I say “Hemorrhagic putamen,” you say
Methanol
When I say “Decreased FDG uptake in the lateral occipital cortex,” you say
Lewy Body dementia
When I say “TORCH with Periventricular Calcification,” you say
CMV
When l say “TORCH with hydrocephalus,” you say
Toxoplasmosis
When I say “TORCH with hemorrhagic infarction,” you say
HSV
When I say “Neonatal infection with frontal lobe atrophy,” you say
HIV
When I say “Rapidly progressing dementia + Rapidly progressing atrophy,” you say
CJD
When I say “Expanding the cortex,” you say
Oligodendroglioma
When I say “Tumor acquired after trauma (LP),” you say
Epidermoid
When l say “The Palate Separated from the Maxilla/Floating Palate,” you say
LeFort 1
When I say “The Maxilla Separated from the Face” or “Pyramidal” you say
LeFort 2
When l say “The Face Separated from the Cranium,” you say
LeFort 3
When I say “Airless expanded sinus,” you say
mucocele
When I say “DVA,” you say
cavernous malformation nearby
When I say “Single vascular lesion in the pons,” you say
Capillary Telangiectasia
When l say “Elevated NAA peak,” you say
Canvans
When l say “Tigroid appearance,” you say
Metachromatic Leukodystrophy
When I say “Endolymphatic Sac Tumor,” you say
VHL
When l say “T 1 Bright in the petrous apex,” you say
Cholesterol Granuloma
When I say “Restricted diffusion in the petrous apex,” you say
Cholesteatoma
When I say “Lateral rectus palsy + otomastoiditis,” you say
Grandenigo Syndrome
When I say “Cochlea and semicircular canal enhancement,” you say
Labrinthitis
When l say “Conductive hearing loss in an adult,” you say
Otosclerosis
When I say “Noise induced vertigo,” you say
Superior Semicircular Canal dehiscence
When I say “Widening of the maxillary ostium,” you say
Antrochonal Polyp
When I say “ Inverting papilloma,” you say
squamous cell CA (10%)
When l say “Adenoid cystic,” you say
perineural spread
When I say “Left sided vocal cord paralysis,” you say
look in the AP window
When I say “bilateral coloboma,” you say
CHARGE syndrome
When I say “Retinal Detachment + Small Eye” you say
PHPV
When I say “Bilateral Small Eye,” you say
Retinopathy of Prematurity
When I say “Calcification in the globe of a child,” you say
Retinoblastoma
When I say “Fluid-Fluid levels in the orbit,” you say
Lymphangioma
When I say “Orbital lesion, worse with Valsalva,” you say
Varix
When I say “Pulsatile Exophthalmos,” you say
NF- I and CC Fistula
When I say “Sphenoid wing dysplasia,” you say
NF-I
When I say “Scimitar Sacrum,” you say
Currarino Triad (Scimitar sacrum is pathognomonic for anterior sacral meningocele, one part of the triad)
When I say “bilateral symmetrically increases T2 signal in the dorsal columns,” you say
B 12 (or HIV)
When I say “Owl eye appearance of spinal cord,” you say
spinal cord infarct
When I say “(smooth) Enhancement of the nerves root of the cauda equina,” you say
guillain barre
When I say “Subligamentous spread of infection,” you say
TB
etiology of Sturge Weber
maldeveloped draining veins
all phakomatosis except this 1 are AD
Sturge Weber (NF I, NF -2, TS, and VHL are AD)
Most Common Primary Brain Tumor in Adult
= Astrocytoma
tumor that Calcifies 90% of the time
Oligodendroglioma
benign normal variant that can show restricted diffusion in a ventricle
Choroid Plexus Xanthogranuloma
T1 bright pituitary
Pituitary Apoplexy
T2 bright pituitary
Rathke Cleft Cyst
calcified pituitary
craniopharyngioma
CP Angle - Invades Internal Auditory Canal
= Schwannoma
CP Angle - Invades Both Internal Auditory Canals
= Schwannoma with NF2
CP Angle- Restricts on Diffusion
= Epidermoid
Peds - Arising from Vermis
Medulloblastoma
Peds- 4th ventricle “tooth paste” out of 4th ventricle
Ependymoma
Adult myelination pattern on MR is seen at what age
TI at I year, T2 at 2 years
what regions are myelinated at birth?
Brainstem and posterior limb of the internal capsule
what 2 CNs are not in the cavernous sinus (but are close by)
CN2 and CNV3
what variant vessel increases risk of aneurysm?
persistent trigeminal artery (vertebral to carotid)
Subfalcine herniation can lead to infarct in what territory
ACA infarct
ADEM lesions will NOT involve the
calloso-septal interface.
Post Radiation changes don’t start for
2 months (there is a latent period).
first thing that atrophies in AD
Hippocampal atrophy is first with Alzheimer Dementia
most common TORCH
CMV
toxo abscess: diffusion?
Toxo abscess does NOT restrict diffusion
which low grade tumors can enhance?
JPA and Ganglioglioma can enhance and are low grade
most common single fracture
nasal bone
most common fracture pattern
ZMC complex/tripod
Supplemental oxygen can mimic
SAH on FLAIR
most common location for hypertensive hemorrhage
putamen
hyperacute (<6hr) stroke MRI findings
Restricted diffusion without bright signal on FLAIR
Enhancement of a stroke: Rule of 3s
starts at day 3, peaks at 3 weeks, gone at 3 months
Most Common systemic vasculitis to involve the CNS
PAN
most common type of crainosynostosis
Scaphocephaly
Piriform aperture stenosis is associated with
hypothalamic pituitary adrenal axis issues.
most common primary petrous apex lesion
Cholesterol Granuloma
absence of the bony modiolus in 90% of cases
Large vestibular aqueduct syndrome
The main vascular supply to the posterior nose is
the sphenopalatine artery (terminal internal maxillary artery).
Sjogrens gets what unusual lymphoma
Sjogrens gets salivary gland lymphoma
Most common intra-occular lesion in an adult
Melanoma
how long is nerve root enhancement normal after surgery?
6 weeks
what if you see nerve root enhancement > 6 weeks after surgery?
it’s arachnoiditis
most important factor for outcome of traumatic cord injury
hemorrhage in the cord
Currarino Triad:
Anterior Sacral Meningocele, Anorectal malformation, Sarcococcygeal osseous defect
most common type of spinal AVF
Type I Spinal AVF (dural AVF) is by far the more common.
Herpes spares the
Herpes spares the basal ganglia (MCA infarcts do not)
Nuc med scan positive in esthesioneuroblastoma
Octreotide scan will be positive for esthesioneuroblastoma
Nuc med scan positive in Warthins tumor
pertechnetate
symmetric restricted diffusion in bilateral hippocampi
hypoxic-ischemic encephalopathy (other commonly affected areas are the deep gray nuclei and cortex)
ddx (4) enhancing, intradural/extramedullary lesion
meningioma, schwannoma, neurofibroma, or metastatic disease.
most common benign tumor in the submandibular and parotid gland?
Benign Mixed Tumor (An easy way to remember the incidence of benign mixed tumor is that the percentage is large in the largest gland (80% in parotid), smaller in the mid-sized gland (50% in submandibular gland) and small in the smallest gland (20% in sublingual gland).)
mylohyoid muscle
mylohyoid muscle
Globus pallidus symmetric T2/FLAIR hyperintensity
CO poisoning (+ white matter hyperintensity)
