Neuroimaging

Question 1

Functional SPECT shows:

Temporo-pareital hypoperfusion

Answer 1

Alzheimer’s Disease

Question 2

CT shows:
generalised cerebral atrophy and ventricular enlargement
reduced medial temporal lobe width
periventricular areas of hypoattenuation

Answer 2

Alzheimer’s Disease

Question 3

MRI shows:
medial temporal lobe atrophy
periventricular white matter lesions (hyperintensities on proton density and T2-weighted MRI scans)

Answer 3

Alzheimer’s Disease

Question 4

CT and MRI shows:
infarcts
extensive deep white matter lesions

Answer 4

Vascular Dementia

Question 5

Functional SPECT shows:

patchy multifocal pattern of hypo perfusion

Answer 5

Vascular Dementia

Question 6

CT and MRI shows:
generalised ventricular enlargement
relative preservation of medial temporal lobe
periventricular white matter lesions

Answer 6

Lewy Body Dementia

Note:
White matter changes similar to Alzheimer’s disease but less extensive than vascular dementia.

Question 7

Functional SPECT shows:
posterior deficits
reduced D2-receptor and dopamine transporter density

Answer 7

Lewy Body Dementia

Question 8

CT and MRI shows:

frontal lobe atrophy

Answer 8

Frontotemporal Dementia

Question 9

Functional SPECT shows:

anterior perfusion deficits

Answer 9

Frontotemporal Dementia

Question 10

Deep white matter hyper intensities

Answer 10

Late Life Depression

Late onset depression is associated with deep white matter hyperintensities on T2 weighted brain MRI. This vascular depression hypothesis (Alexopoulous, 1997) is associated with a poorer response to treatment.

Question 11

Reduced D2 receptor density and dopamine transporter

Answer 11

Lewy Body Dementia

Question 12

High intensity signal in the thalamus

Answer 12

Creutzfeld Jakob disease

Variant CJD has the pulvinar sign which is a high intensity signal in the pulvinar nucleus of the thalamus.

Question 13

Mesial temporal sclerosis on MRI

Answer 13

Complex Partial Seizures

Mesial temporal sclerosis (MTS) also commonly referred to as hippocampal sclerosis. Associated with with intractable temporal lobe epilepsy.

Question 14

MRI shows:
high T2 signal intensity in mesial temporal lobes
bilateral involvement common
similar appearance to herpes simplex encephalitis

Answer 14

Limbic Encephalitis

Also known as autoimmune limbic encephalitis. Can be paraneoplastic or non-neoplastic.