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15. Neurology, Neuroanatomy, Neuroimaging, Neurostimulation > Neuroimaging > Flashcards

Neuroimaging Flashcards

1
Q

when should you order a CT head in the setting of psychosis

A

first episode psychosis WITH neuro sx, atypical clinical picture and older age

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2
Q

would you pick CT or MRI in the following presentation:

sustained confusion

A

MRI

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3
Q

would you pick CT or MRI in the following presentation:

screening exam

A

CT

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4
Q

would you pick CT or MRI in the following presentation:

acute hemorrhage

A

CT

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5
Q

would you pick CT or MRI in the following presentation:

atypical clinical findings

A

MRI

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6
Q

would you pick CT or MRI in the following presentation:

delirium

A

CT

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7
Q

would you pick CT or MRI in the following presentation:

subtle cognitive deficits

A

MRI

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8
Q

would you pick CT or MRI in the following presentation:

abrupt personality changes w neuro signs and symptoms

A

MRI

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9
Q

would you pick CT or MRI in the following presentation:

calcified lesions

A

CT

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10
Q

would you pick CT or MRI in the following presentation:

skull injury

A

CT

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11
Q

would you pick CT or MRI in the following presentation:

brain injury

A

MRI

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12
Q

would you pick CT or MRI in the following presentation:

patients who cannot tolerate a longer exam

A

CT (for those who cant tolerate longer MRI)

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13
Q

list advantages to CT

A

SENSITIVE in detecting intracranial HEMORRHAGE, mass effect, hydrocephalus, middle ear/temporal bone pathology, bone lesions and skull #s

FOREIGN BODIES are obvious on CT

good SCREENING exam for evaluating brain for presence of abnormalities

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14
Q

what are disadvantages of CT

A

radiation

cost

availability

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15
Q

list 2 advantages to MRI

A

NO radiation exposure

superior to CT for SOFT TISSUE contrast and multi-planar capabilities

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16
Q

list disadvantages to MRI

A

cost

limited availability

long acquisition time

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17
Q

what would be the neuroimaging modality of choice for assessing subacute and chronic brain bleeds

A

MRI

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18
Q

MRI is LESS sensitive than CT for which two conditions

A

subarachnoid hemorrhage and calcifications

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19
Q

how are CT images constructed

A

based on different densities of stuff in the head

20
Q

what are T1 weighted MRI sequences best for

A

best for ANATOMICAL DETAIL

21
Q

what are T2 weighted MRI sequences best for

A

usually best for PATHOLOGICAL LESIONS

22
Q

how do you distinguish between T1 and T2 weighted images on MRI

A

mnemonic: Water is White on T2 –> World War 2 (WW2)

23
Q

what is currently the most sensitive MRI technique for detecting a cerebrovascular incident

A

diffusion weighted imaging (DWI)

24
Q

what is another use for DWI MRI

A

detection of diffuse axonal injury in the brain

25
Q

what MRI technique is used to detect EDEMA in the brain

A

FLAIR

26
Q

what is the standard CT scan in a trauma case

A

non con CT

27
Q

what brain abnormality is associated with “thunderclap headache”

A

subarachnoid hemorrhage

28
Q

what imaging technique would I choose if i suspect acute ischemic stroke within 6 hours

A

DWI MRI

CT can help rule out hemorrhagic stroke, which is important. But CT can be normal in ischemic stroke within 3-6 hours but DWI MRI is able to detect infarcts within minutes of the event

29
Q

what are the most common CNS tumors

A

Glial tumors

30
Q

what is the modality of choice for detection of pituitary tumor

A

MRI

31
Q

what is the most sensitive technique to detect meningitis

A

MRI

–but contrast enhanced CT can also be used

*NON con CT is NORMAL in more than 50% of cases so not a good test for meningitis

32
Q

what are “Dawsons fingers”

A

a highly specific sign of MS on MRI

represent demyelinating plaques through the corpus callus

arranged at right angles along the medullary veins

33
Q

what normal age-related changes may be seen on neuroimaging

A

atrophy

increased ventricular size

non-specific white matter changes

34
Q

can neuroimaging be used to rule IN alzheimers disease?

A

no–> neuroimaging has low specificity in AD

is used to rule out other causes

35
Q

what do you see on CT in AD

A

diffuse cerebral atrophy

enlarged ventricles

WIDENED SULCI

can also see medial temporal love atrophy on MR

36
Q

what is Pick disease

A

a progressive dementia with death occurring 2-3 years after onset

typically affects frontal and/or temporal lobes causing apathy, lack of initiative, personality change

speech, language change begin early and progress quickly

incontinence can occur early (unlike in AD, where continence is usually preserved until late in disease)

37
Q

what brain changes are seen in Pick disease

A

swollen neurons (pick cells)

neuronal inclusions (pick bodies)

neuronal loss, gliosis, brain strophy

38
Q

what do you see on CT in Pick disease

A

prominent atrophy of the frontal and/or temporal lobes

*on MRI, there is sulci prominence wiht atrophy of insula, inferior frontal and superior frontal lobes and enlargement of frontal or temporal horns of the lateral ventricles

39
Q

what do you see on neuroimaging in huntingstons disease

A

significant caudate atrophy

40
Q

is neuroimaging useful in parkinsons

A

not generally useful

41
Q

what imaging technique is useful in assessing normal pressure hydrocephalus

A

MRI

*T2 weighted

42
Q

what do SPECT look at

A

uses combo od CT and radioactive tracer to evaluate cerebral blood flow and to look for areas of hypoperfusion in the brain

43
Q

what are DAT-SPECT scans and what are they good for

A

“DAT” = dopamine transporter scans

asses dopamine uptake in the BASAL GANGLIA in vivo

good for differentiating LBD from AD as there is a greater reduction of dopamine terminals in the striatum in LBD comapred to their relative preservation in AD

*DAT-SPECT can be abnormal in other neurodegenerative disorders where dopamine tarnsmission is affected ie FTD, corticobasilar degeneration, PSP, MSA

44
Q

what finding on SPECT suggests AD

A

medial temporal parietal lobe hypoperfusion

45
Q

what finding on SPECT suggests parkinsons/LBD

A

parietal-occipital distribution of hypoperfusion

46
Q

what does EEG measure

A

measures electricity generated by neural activity –> measures the electricity generated when clusters of neurons fire together

47
Q

alpha wave intrusions into delta sleep on EEG (“alpha-delta sleep”) can be seen in what disorders

A

MDD and fibromyalgia

15. Neurology, Neuroanatomy, Neuroimaging, Neurostimulation (4 decks)

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