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A DDx > Neuro DDx > Flashcards

Neuro DDx Flashcards

1
Q

Hypo intense T2 brain lesions

A

Metastasis containing mucin: GI adenocarcinomas.

Hypercellular tumours: lymphoma, medulloblastoma, germinoma, some glioblastomas may be hypointense.

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2
Q

Hyper intense T1 tumours

A

Metastatic melanoma
Fat containing tumours: dermoid, teratoma.
Heamorrhagic mets: “MR CT BB”: Melanoma, RCC, Choriocarcinoma, Thyroid, Bronchogenic, Breast.

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3
Q

Trans-callosal Mass

A

Glioblastoma
Lymphoma
Demyelinating Disease.

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4
Q

Tumours / lesions with a cyst and an enhancing nodule:

A

Neurocysticercosis
Juvenile pilocytic astrocytoma
Haemangioblastoma
Pleomorphic xanthoastrocytoma (temporal lobe, dural thickening)
Desmoplastic infantile ganglioglioma
Ganglioglioma (temporal lobe, Ca++, calvarial remodelling).

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5
Q

Intra ventricular tumours:

A

Central neurocytoma
Choroid Plexus papilloma / carcinoma (cauliflower like)
Intra ventricular meningioma
Subependymal giant cell astrocytoma (tuberous sclerosis)
Subependymoma

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6
Q

Ring enhancing basal ganglia mass in immunocompromised:

A

Lymphoma

Toxoplasmosis

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7
Q

Posterior Fossa mass in Child

A

Medulloblastoma (Hyperdense on Ct, diffusion restriction).
Juvenile Pilocytic astrocytoma (Cystic mass with enhancing nodule)
Ependymoma (Intra ventricular, pushes through foramina)
Haemangioblastoma (Cystic mass with enhancing nodule, flow voids, hx vHL)
ATRT (young, agressive appearances, renal mass)

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8
Q

Posterior fossa mass in Adult:

A

Tumour like conditions:

  • Metastasis (Hx of primary, enhancing mass with oedema, multiple)
  • Haemangioblastoma (cystic mass with enhancing nodule, flow voids, Hx vHL).
  • Astrocytoma (Minimal / little enhancement)
  • Medulloblastoma (young adult, lateral location)
  • Choroid Plexus Papilloma: (4th ventricle, enhancing papillary mass with hydrocephalus)

Infarction: e.g. PICA

Vascular malformation

Hypertensive haemorrhage.

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9
Q

CPA Mass

A 
"AMEN"
Acoustic Schwannoma (ice cream cone)

Meningoma

Ependymoma

Neuroepithelial cyst:

  • Epidermoid Cyst (doesnt suppress on FLAIR and bright diffusion restriction.
  • Arachnoid cyst (CSF intensity, does not diffusion restrict)

Aneursym (flow void)
Intra axial neoplasm with extension: exophytic glioma, medulloblastoma, ependymoma.

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10
Q

Intrinsic Pituitary Mass:

A

Normal sizes:

  • child upto 6mm,
  • males / post menopausal women upto 8mm,
  • menstruating females upto 12mm, pregnant / post partum / lactating upto 14mm.

Pituitary hyperplasia
Pituitary microadenoma
Pituitary macroadenoma
Lymphocytic hypophysitis
Granulomatous Hypophysitis (Sarcoidosis, Wegener granulomatosis, Tb, LCH)
Rathke’s cleft cyst, usually extrinsic to pituitary

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11
Q

Suprasellar Mass:

A

“SATCHMO”
Sarcoidosis / Supra sellar extension adenoma
Aneursym
Teratoma / Tolosa Hunt
Craniopharyngioma / Cleft cyst (Rathke’s)
Hypothalamic Glioma (adults) / Hypothalamic Hamartoma (children)
Meningioma / Metastases (breast).
Optic Nerve glioma

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12
Q

Supra sellar mass in Child:

A

Craniopharyngioma: Calcified, enhancing complex cystic mass, distinct from pituitary.
Optic pathway glioma: T2 hyperintense, enhancing mass, signs of NF1.
Germ cell tumour: avidly enhancing midline mass - germinoma. Contains fat - dermoid.
Hypothalamic hamartoma: non enhancing grey matter isointense mass. Gelastic seizures, precocious puberty.
LCH hypophysitis: enhancing enlarged pituitary stalk. Diabetes insipidus.

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13
Q

Supra sellar Mass adult:

A

Pituitary macroadenoma extension: pituitary mass extending superiorly. Expansion of sella.
Meningioma: intense enhancement with normal sella. Enhancing tail. Adjacent hyperostosis. Narrows adjacent vasculature.
Craniopharyngioma: calcified, enhancing complex cystic mass. Distinct from pituitary.
Rathkes cleft cyst: non enhancing cystic mass without Ca++, claw sign.
Aneursym: enhancement equal to blood pool, calcified rim.
Lymphocytic or granulomatous hypophysitis: enhancing enlarged pituitary stalk. Diabetes insipidus.

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14
Q

Intrinsic Pineal Mass:

A

“elevate internal cerebral veins”

Germinoma: avid enhancement, hypderdense, isointense, dark ADC, engulfs with central Ca++. Neuro axis seeding

Teratoma: Heterogenous, intra lesional fat, central course Ca++.

Pineal Cyst:

Pineocytoma: internal enhancement, cystic components. adults 20s-30s. Neuro axis seeding

Pineoblastoma: young children, tri lateral retinoblastoma, obstructive hydrocephalus, invasion restricted diffusion, exploded / blasts Ca++. Leptomeningeal spread.

Metastases

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15
Q

Extra Pineal Mass:

A

Gliomas (tectum, midbrain, splenium)
Vein of Galen aneurysm.
Meningioma: depress internal cerebral veins
Quadrigeminal / tectal plate lipoma: agenesis corpus callosum

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16
Q

Cortically Based Tumour:

A 
"PDOG"
Pleomorphic Xanthoastrocytoma
DNET
Oligodendroglioma
Ganglioglioma
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17
Q

Intraparnechymal Haemorrhage:

A

HTN: Basal ganglia, thalamus, cerebellum. Microbleeds T2*, prior lacunar infarcts.

Amyloid angiopathy: normotensive elderly, lobar / cortical location. Microbleeds T2*

Aneurysmal haemorrhage: extensive SAH, aneurysm adjacent to haematoma.

Arteriovenous malformation: young patients. Enlarged feeding vessel, adjacent encephalomalacia.

Dural AV fistula: Haemorrhage adjacent to cavernous sinus or posterior fossa, enlarged meningeal artery or cortical vein.

Venous thrombosis: para sagittal or bilateral thalamic haemorrhage, young patient. Increased density cortical vein / dural sinus.

Haemorrhagic neoplasm: Gliobastoma, Mets (Choriocarcinoma, Thyroid, Melanoma, RCC, Breast, bronchogenic). More oedema than expected, more heterogenous signal, multiple enhancing lesions.

Cavernous malformation: angiographically occult. Adjacent DVA, multiple dark spots on T2*.

Haemorrhagic transformation of infarct:

Vasculitis: beaded vessels. Multifocal T2 bright deep white matter.

Moyamoya: progressive stenosis intracranial ICA causing fragile lenticulostriate vessels. Puff of smoke angiography. Multiple collateral vessels.

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18
Q

Intra medullary spinal cord lesion

A 
" I'D HEAL"
Infarction
Demyelination
Haemangioblastoma
Ependymoma
Astrocytoma
Lipoma
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19
Q

T2 Hyper intense Basal Ganglia

A

“LINT”

Lymphoma
Ischaemia
Neurodegenerative conditions:
 - autoimmune encephalitis
 - CJD
 - Extra pontine myelinosis
 - Huntington disease
 - Mitochondrial diseases: Leigh disease
 - Wilson disease
Toxins:
 - Carbon monoxide
 - Cyanide
 - Organophosphates
 - Hypoglycaemia
 - Methanol
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20
Q

Calcified glial tumours frequency

A 
"Old Elephants Age Gracefully"
Oligodendroglioma
Ependymoma
Astrocytoma
Gliobastoma
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21
Q

NF 1 Features

A 
"CAFE SPOT"
Cafe au lait spots
Axillary or inguinal freckling
Fibromas
Eye harmatomas - Lisch nodules
Skeletal abnormalities: posterior vertebral scalloping, sphenoid wing dysplasia, leg bowing.
Postive FHx
Optic Tumour - Optic nerve glioma
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22
Q

NF 2 Features

A

“MISME”
Multiple inherited Schwannomas
Meningiomas
Ependymomas

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23
Q

Ring enhancing Lesion

A 
"MAGIC DR"
Metastasis
Abscess
Glioblastoma
Infarct / Inflammatory - neurocysticossis / tuberculoma / toxoplasmosis
Contusion
Demyleinating
Radiation necrosis
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24
Q

Posterior vertebral scalloping:

A 
"SALMON"
Spinal cord tumour: ependymoma, astrocytoma, schwannoma.
Achrondroplasia, acromegaly.
Loeys Dietz syndrome
Marfans / mucopolysacchirdoses
Osteogenesis
NF 1
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25
Q

Intra dural extra medullary mass

A 
"No More Spinal Masses"
Neurofibroma
Meningioma
Schwannoma
Metastases.
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26
Q

Multiple Endocrine Neoplasia types:

A

MEN 1: “PPP”

  • Pituitary adenoma
  • Pancreatic islet cell tumour: gastrinoma.
  • Parathryoid hyperplasia / adenoma

MEN 2A: “PMP”

  • Phaeochromocytoma
  • Medullary thryoid cancer
  • Parathyroid hyperplasia

MEN 2B: “MPM”

  • Medullary thyroid cancer
  • Phaeochromocytoma
  • Mucosal neuromas
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27
Q

von Hippel Lindau disease features:

A

“HIPPEL”
Haemangioblastoma
Increased risk of RCC
Pheochromocytoma
Pancreatic lesions (cyst, cystadenoma, cystadenocarcinoma)
Eye dysfunction: retinal haemangioblastoma, endolymphatic sac tumour.
Liver / renal / pancreatic cysts.

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28
Q

Confluent White matter lesions:

A

Demyelinating disease:

  • MS: Periventricular Dawson fingers, usually no mass effect, incomplete ring of enhancement.
  • ADEM
  • Lyme disease

Neoplasm:

  • Gliomatosis cerebri
  • anaplastic astrocytoma
  • Lymphoma

Progressive multifocal leukoencephalopathy: (PML)

  • periventricular subcortical WM T2 hyperintensity
  • without mass effect
  • Involves U-fibres (lots of “U” in PML)
  • No enhancement, or faintly peripheral.
  • No atrophy.

HIV encephalitis:

  • diffuse bilateral, sparing sub cortical WM ( no “U” in HIV encphalitis),
  • cerebral atrophy.
Vascular:
Ageing normal brain
Arteriosclerosis
Chronic hypertensive encephalopathy: 
 - BG lacunae, periventricular T2 bright,
 - microhaemorrhages.
Multi infarct dementia
Cerebral amyloid:
CADASIL:
- Symmetric sub cortical WM, anterior temporal lobe or para median frontal lobe, external capsule

Radiation

Inherited metabolic disorders:

  • Alexander disease (frontal)
  • Metachromatic leukodystrophy (“Middle” central)
  • X Linked adrenoleukodystrophy (posterior)
  • Canavan disease: peripheral lateral
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29
Q

Multiple parenchymal Calcifications:

A 
Basal Ganglia:
 - Thyroid / parathryoid
 - Inflammatory / infectious
Cortex:
 - Neurocysticercosis
 - Tb
 - Sturge Weber
Grey White junction:
 - Fahr disease
 - Tuberous sclerosis complex
 - Mets: treated
 - Radiation.
Periventricular:
 - Fahr disease
 - TORCH infection
 - Tuberous sclerosis complex
NF 2.

Neurocysticercosis: multiple, small Ca++ lesions.
Cavernous malformation: variable size
TB: Healed granuloma, target sign.
Tuberous Sclerosis: Ca++ subependymal nodules.
Sturge Weber Syndrome: gyral, tram track Ca++, atrophy
Mets:
TORCH: CMV periventricular Ca++.
Fahr disease: extensive BG Ca++
MELAS: cortical & BG lacunae, BG Ca++

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30
Q

Basal Ganglia Ca++:

A

Infection:

  • Neurocysticercosis
  • TB
  • Toxoplasmosis
  • Congenital infections: CMV, HIV

Metabolic:

  • Fahr Disease
  • Mitchondrial Disorders; Leigh Syndrome

Endocrine:

  • hypo PTH, / hyper PTH
  • hypothyroidism

Hypoxic Ischaemic Injury

Radiation.

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31
Q

T1 Hyperintense Basal Ganglia:

A 
NF1
Hepatic encephalopathy
Hyperalimentation
Hypoxic ischaemic injury
Hypotensive cerebral infarction
Carbon monoxide poisoning
Kernicterus
Wilson disease
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32
Q

Cerebellar Hemisphere Mass:

A 
Cerebellar ischaemia / infarction
Hypertensive bleed
Medulloblastoma
Pilocytic astrocytoma
haemangioblastoma
Mets
Tumefactive demyelinating: MS, ADEM.
Abscess
Cavernous malformation
Arteriovenous malformation
Atypical teratoid rhabdoid tumour.
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33
Q

Brain tumour child > 1 year by location

A

Posterior Fossa:

  • Pilocytic astrocytoma
  • Medulloblastoma
  • Ependymoma
  • Brainstem glioma

Supra tentorial:

  • Diffuse astrocytoma low grade
  • Craniopharyngioma
  • SEGA (TS)

Midline pineal / supra sellar:

  • Germinoma
  • Teratoma
  • Phineoblastoma

Intra axial: peripheral and cortical:

  • DNET
  • Pleomorphic xanthoastrocytoma
  • Ganglioglioma
  • Oligodendroglioma

Intra axial Deep and hemispheric:

  • Anaplastic astrocytoma
  • CNS embryonal tumour
  • Glioblastoma

Extra axial:
- Chorid plexus tumour
NF2

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34
Q

Thickened Dura

A 
Post operative
Dural Mets
Chronic sub dural haematoma
Intra cranial hypotension
Meningitis
Neurosarcoid
Tb
Syphillis
Metastatic intracranial lymphoma
Meningioma
IgG 4 related hypertrophic pachymeningitis.
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35
Q

Sacral Mass:

A 
Chordoma
Chondrosarcoma
Neurofibroma
Giant Cell tumour
Osteoblastoma.
Plasmacytoma
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36
Q

Unilateral thalamic Lesion

A 
Lacunar infarction
Hypertensive intracranial haemorrhage
NF1
Low grade astrocytoma
Glioblastoma
Anaplastic astrocytoma
ADEM (usually bilateral)
Cavernous malformation 
AV malformation
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37
Q

Bithalamic lesion

A

Reduced diffusion:

  • artery of Percheron infarct
  • Bilateral PCA infarcts
  • Encephalitis (Japanese encephalitis)
  • Hypoxic ischaemic encephalopathy
  • Mitochondrial disorder

Haemorrhagic:

  • Deep venous thrombosis
  • Vasculitis
  • Encephalitis

Symmetrical:

  • Wernicke encephalopathy
  • Osmotic myelinolysis
  • Hypoxic ischaemic encephalopathy.
  • CJD
  • Inborn errors metabolism.
  • Viral encephalitis (japanese) doesnt have to be DWI bright)
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38
Q

MRS Disease summary

A

Gliomas: as grade increases, NAA and creatine decrease, and choline, lipids and lactate increase.

Radiation: Recurrent tumour choline will be elevated. Radiation change NAA, choline, and creatine will all be low.

Ischaemia / infarction: lactate increases. With infarction lipid peak appears.

Infection: NAA is absent. Bacterial abscess shows lactate, alanine, systolic acid and acetate elevation. Choline low / absent in toxoplasmosis, while it is elevated in lymphoma.

PML: elevated myoinositol.
Canavan disease: elevated NAA.
Leigh syndrome: elevated choline, reduced NAA, may have elevated lactate.

39
Q

Herpes encephalitis DDx:

A

Acute cerebral ischaemia
Status epilepticus
Limbic encephalitis
Infiltrating neoplasm / gliomatosis cerebri.

40
Q

Infra tentorial Midline Cyst:

A 
Mega Cisterna Magna
Arachnoid cyst
Neurocysticercosis
Dandy Walker Malformation
Obstructive hydrocephalus with trapped 4th ventricle
Pilocytic astrocytoma
Haemangioblastoma
Epidermoid cyst
Dermoid cyst
41
Q

Cystic appearing posterior fossa lesion:

A 
Mega cisterna magna
Arachnoid cyst
Dandy Walker malformation
Blake Pouch Cyst
Joubert syndrome
Pilocytic astrocytoma
Encephalocele
Obstructive hydrocephalus
Abscess
Epidermoid
Dermoid
Haemangioblastoma
42
Q

Thick Cortex:

A 
Viral encephalitis
Autoimmune encephalitis
Tuberous Sclerosis
Focal cortical dysplasia
PAchygyria poly microgyria
Hemigalencephaly
43
Q

Thin cortex:

A 
aging brain
Obstructive hydrocephalus
Chronic ifarction
General encephalomalacia
Multiple Sclerosis
Alzheimer dementia
Vascular dementia
Parkinson disease
44
Q

Focal Cortical Mass:

A 
Acute cortical ischaemia / infarction
Mets
Pleomorphic Xanthoastrocytoma
Oligodendroglioma
DNET
Ganglioglioma
Diffuse astrocytoma
Cerebritis
Venous infarction
Viral encephalitis
45
Q

Abnormal shape Corpus callosum:

A 
Normal vairant
Callosal dysgenesis
Neoplasm: lipoma, glioblastoma, lymphoma.
Decreased white matter volume
Obstructive hydrocephalus
Marchiafava Bignami
46
Q

Fat like Lesions:

A 
Choroid plexus xanthogranloma
Lipoma
Craniopharyngioma
Teratoma
Dermoid cyst
Petrous apex cholesterol granuloma
White epidermoid
47
Q

Enlarged Cortical Veins:

A 
Developmental Anamoly
AV malformation
Dural arteriovenous fistula
Dural sinus thrombosis
Cortical venous thrombosis
Vein of Galen malformation
48
Q

Enlarged deep veins:

A 
Developmental venous anomaly
AV malformation
Sturge Weber Syndrome
THrombosis deep vein
Thrombosis dural sinus.
Glioblastoma
Intracranial hypotension
49
Q

Solitary parenchymal Ca++

A 
Neurocysticercosis
TB
Cavernous malformation
Oligodendroglioma
Ganglioglioma
Low grade astrocytoma
Pilocytic astrocytoma
50
Q

Multiple parenchymal Ca++

A 
Neurocysticercosis
Multiple cavernous malformations
TB
Tuberous sclerosis complex
Sturge Weber SYndrome
Mets
Oppurtunistic infection in AIDS
TORCH infection
Metabolic diseases: Fahr disease, MELAS.
51
Q

Multiple Hypointense Foci GRE/SWI:

A 
Chronic HTN
Cerebral amyloid angiopathy
Traumatic axonal injury
Mets
Pneumocephalus
Multiple cavernous malformations
Neurocysticercosis
TB
Fat embolisation syndrome
Radiation induced telangiectasia.
52
Q

Cortical Hyperintensity T2 / FLAIR

A 
Acute cerebral ischaemia / infarction
Cerebral contusion
Hypotensive cerebral infarction
status epilepticus
Herpes Encephalitis

Low grade diffuse astrocytoma - T2 FLAIR mismatch can suggest IDH status.

PRES (acute hypertensive encephalopathy)

53
Q

Cortical Enhancement:

A 
Subacute cerebral infarction
herpes encephalitis
Hypotensive cerebral infarction
status epilepticus
Acute hypertensive encephalopathy / PRES
Cerebritis
Malignant glioma
54
Q

T2 Hyperintense Basal Ganglia:

A 
Enlarged perivascular spaces
Hypoxic injury
NF1
ADEM
Vasculitis
Toxic insults: CO, cyanide, methanol.
Metabolic: leigh syndrome, Wilson disease, MELAS.
55
Q

Bilateral Basal Ganglia Lesions:

A 
Enlarged perivascular spaces
Mineralisation
Metallic ion deposition
Lacunar infarction
Hypoxic ischaemic injury
Glioma / lymphoma.
Infection: cryptococcus, toxoplasmosis, viral encephalitis.
56
Q

Bithalamic lesions:

A 
Arterial ischaemia
Venous ischaemia
Acute disseminated encephalomyelitis
VIral encephalitis
astrocytoma
PRES
MS
Lymphoma
Wenicke encephalopathy.
57
Q

Restricted Diffusion:

A 
Cerebral ischamie / infarction.
abscess
Empyema
Epidermoid cyst
Intracerebral haematoma
Choroid plexus cyst
Ventriculitis
Diffuse axonal injury
Meningioma
Lymphoma
Status epilepticus
Osmotic demyelination
58
Q

Hyperdense dural sinus:

A

Physiologic hyperdensity
Dural sinus thrombosis
Polcythema

59
Q

Multiple Parenchymal Ca++

A 
Neurocysticercosis
Multiple cavernous malformations
TB
Tuberous sclerosis COmplex
Sturge Weber SYndrome
Parenchymal Mets
Remote Brain injury.
TORCH infection
Fahr Disease
MELAS
60
Q

Solitary Ring Enhancing Lesion

A 
Parenchymal Met
GBM
Abscess
Sub acute intra cerebral haematoma
Subacute cerebral infarction
Radiation necrosis
Tumefactive demyelination
Neurocysticercosis
Lymphoma
Toxoplasmosis
Tuberculoma
Ganglioglioma
Pilocytic astrocytoma
61
Q

Multiple ring enhancing lesions:

A 
Parenchymal Mets
Abscess
MS
ADEM
Neurocysticercosis
TB
Oppurtunistic infection
Lymphoma
Multifocal GBM
62
Q

Cyst with Nodule

A 
Neurocysticercosis
Pilocytic astrocytoma
Ganglioglioma
Haemangioblastoma
PXA
Demosplastic infantile ganglioglioma
Intraparenchymal schwannoma.
Mets
Glioblastoma
Abscess
Toxoplasmosis
DNET
Supratentorial ependymoma
63
Q

Sulcal / Cisternal Enhancement

A 
Meningitis
Meningeal carcinomatosis
Lymphomatous Meningitis
Neurocysticercosis
TB meningitis
Neurosarcoid
Sturge Weber
Fungal disease
Aneurysmal SAH
64
Q

Ependymal Enhancement:

A 
Developmental Venous anomaly
MS
Ventriculitis
Oppurtunistic infction in AIDS
Neoplasm with CSF seedig
Lymphoma
Neurosarcoid
TB
65
Q

Large Ventricles:

A

Aging brain
Intraventricular obstructive hydrocephalus
Extraventricular obstructive hydrocephalus
Obstructive hydro cephalus: shunt failure
Encephalomalacia
Normal pressure hydrocephalus
Enlarged subarachnoid spaces

66
Q

Small ventricles:

A 
CSF shunts and complications
Cerebral oedema
Herniation syndromes
Hypoxic ischaemic injury
Cerebral infection
Intracranial HTN and Hypotension
67
Q

Asymmetric lateral ventricles:

A 
Normal variant
Extrinsic mass effect
Encephalomalacia
Intraventricular haemorrhage
Herniatin syndromes
Surgical defects
Obstructive hydrocephalus
Choroid plexus cyst
Ventriculitis
68
Q

Irregular lateral ventricles:

A 
CSF shunt  / complication
Surgical defect
Periventricular leukomalacia
Chronic cerebral infarction
Porenchepahlic Cyst
Chiari 2
Heterotopic Grey matter
Tuberous sclerosis complex
Mets
69
Q

Large Brainstem:

A 
Brainstem glioma
HTN intracranial Haemorrhage
Intracranial hypotension
Osmotic demyelination syndrome
Acute cerebral ischaemia / infarction
Demyelination
Cavenrous malformation
70
Q

Pontine lesion:

A 
Ischaemic rarefaction / arteriosclerosis
Acute cerebral ischamia / infarction
HTN haemorrhage
Vascular malformation: capillary telangiectasia, cavernous malformation.
Demyelination
Diffuse infiltrative pontine glioma
Malignant glioma
Pilocytic astrocytoma
Wallerian degeneration
PRES
Osmotic demyelination syndrome
71
Q

Medulla Lesion:

A 
Lateral medullary infarct
Medial medullary infarct
Wallerian degeneratino
Demyelination
Cavernous malformation
Paeds: diffuse fibrillary astrocytoma
Adults: glioma, haemangioblastoma.
72
Q

Brain tumour child < 1year:

A

Posterior Fossa:

  • Pilocytic astrocytoma
  • Medulloblastoma
  • Ependymoma
  • Brainstem glioma

Supratentorial:

  • Diffuse low grade astrocytoma
  • Crainopharyngioma
  • SEGA

Midline Pineal / Supra sella:

  • Germinoma
  • Teratoma
  • Pineoblastoma

Intra axial peripheral and cortical:

  • DNET
  • PXA
  • Ganglioglioma
  • Oligodendroglioma

Intra axial deep white matter and hemispheric:

  • Anaplastic astrocytoma
  • CNS embryonal tumour
  • Glioblastoma.
73
Q

Bubbly intra ventricular mass:

A 
Choroid plexus cyst
Neurocysticercosis
Choroid plexus papilloma / carcinoma
Central neurocytoma
Ependymoma
Subependymoma
Ependymal cyst
Epidermoid cyst
74
Q

Ependymal / subependymal Lesions:

A 
Tuberou Sclerosis complex
SEGA
Focal cortical dysplasia
Heterotopic Grey Matter
Developmental venous anomaly
MS
GBM
Lymphoma
Ependymoma
Ventriculitis
Subependymoma
Neurosarcoid
75
Q

Ependymal Enhancement:

A 
Developmental venous anomaly
MS
Ventriculitis
Oppurtunistic infection AIDS
CSF tumour seeding
CNS lymphoma
Neurosarcoid
Neuromyeltis optica
TB
LCH
76
Q

Periventricular Enhancing Lesions:

A 
MS / tumefactive demyelination
ADEM
GBM
Lymphoma
Mets
Abscess
Septic emboli
Toxoplasmosis
Neurocysticercosis
Neurosarcoid
77
Q

Thick Infundibular Stalk:

A 
Neurosarcoid (adult)
Germinoma (young)
Basilar Meningitis
LCH (young)
Lymphocytic Hypophysitis (adult)
Lymphoma (adult)
78
Q

Solitary Dural Based Mass:

A 
Epidural Haematoma
Meningioma
Meningeal Mets
Neurosarcoid
Metastatic lymphoma
Empyema
Benign mesenchymal tumours
Leukaemia
79
Q

Multiple Dural Based Mass:

A 
Meningioma
Meningeal Mets
Chronic Subdural Haematomas
Neurosarcoid
NF2
Lymphoma
Erdheim-Chester Disease.
80
Q

Cystic CPA Mass:

A 
Epidermoid
Arachnoid Cyst
Vesticular Schwannoma with intramural Cyst
Haemangioblastoma
Large endolymphatic sac anomaly
Neurocysticercosis
Neuroenteric cyst
81
Q

CSF like Parenchymal Lesions:

A 
Enlarged perivascular space
Encephalomalacia
Lacunar infarction
Neurocysticerosis
Porencephalic Cyst
MS
Hippocampal sulcus remnants
Cryptococcus
82
Q

CSF Like Extra Axial Fluid Collection:

A 
Enlarged subarachnoid spaces
Mega Cisterna Magna
Chronic Subdural Haematoma
Subdural hygroma
Subdural effusion
Arachnoid cyst
83
Q

Hypodense Extra Axial Mass:

A 
Arachnoid cyst
Chronic Subdural Haematoma
Post op epidural fluid
Pneumocephalus
Neurocysticercosis
Lipoma
84
Q

Choroid Plexus Lesion:

A 
Choroid plexus cyst
Enlarged choroid plexus
Choroid plexus papilloma
Meningioma
Intra ventricular Mets
Ventriculitis
85
Q

Enlarged perivascular Spaces:

A 
Normal Variant
Aging brain
Tumefactive perivascular spaces
Cryptococcosis
Mucopolysaccharidoses
CADASIL
86
Q

Multi focal WM abnormalities in child:

A 
MS (teens)
ADEM
Neuromyelitis optica
PRES
Tuberous sclerosis complex
NF1
Viral encephalitis
Metabolic brain disease: usually symmetrical.
Lyme disease: CrN enhancement
CADASIL (usually adults).
87
Q

White matter disease with sparing subcortical U-fibres:

A 
Chronic small vessel ischaemic changes.
CADASIL
HIV encephalopathy
Toxic leukoencephalopathies:
 - Chasing the dragon
 - Radiation / chemo.
Leukodystrophies:
 - X-linked adrenoleukodystrophy
 - Metachromatic leukodystrophy
 - Krabbe disease.
Inborn errors metabolism:
 - Phenylketonuria
 - Maple syrup urine disease
88
Q

White matter disease involving subcortical U-fibres early:

A

MS
Progressive multifocal leukoencephalopathy (PML)
Acute disseminated encephalomyelitis (ADEM)
Canavan disease
Alexander disease

89
Q

Imaging features Intracranial Hypotension:

A 
Pachymeningeal enhancement
Venous distension - dural sinuses
Enlarged pituitary gland
Eventual subdural effusions and haematomas
Reduced CSF volume: 
 - tonsillar ectopia, 
 - drooping splenium, 
Reduced maillopontine distance.
90
Q

Imaging features of intracranial hypertension:

A 
MOVES
M: Meckel's cave enlargement
O: optic disc protrusion
V:  venous sinus stenosis
E:  empty sella
S: slit like ventricles

Can have tonsillar ectopia
Common fat neck soft tissues.

91
Q

Increased T2 signal basal ganglia / thalami in a child:

A 
Ischaemia
Carbon monoxide poisoning
Wilson disease
Mitochondrial disorder
Kernicterus
osmotic demyelination
92
Q

Cerebellar Atrophy:

A 
Alcohol abuse
anticonvulsant therapy
Paraneoplastic syndrome
Sporadic olivo-ponto-cerebllar atrophy
Cerebello-pontine degeneration
Friedreich ataxia.
93
Q

Prominent periventricular / basal ganglia cystic lesions:

A 
Virchow robin spaces
Lacunar infarct
Infection:
 - Neurocysticercosis
 - Cryptococcus
Cystic neoplasm
Neuroglial cyst

A DDx (14 decks)

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