Neuroradiology 1 Flashcards

1
Q

What is a blooming artifact?

A

susceptibility artifact encountered on some MRI sequences in the presence of paramagnetic, the lesion appears larger than it actually is

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2
Q

What MR sequences maximize blooming artifact effects?

A

One of the most powerful and widely available sequences which maximizes blooming artifact to great effect is susceptibility-weighted imaging (SWI). Gradient echo and low B-value diffusion weighted imaging may also be useful in the absence of a dedicated susceptibility weighted sequence.

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3
Q

What types of compounds exhibit blooming artifact?

A

hemosiderin from prior hemorrhage, calcification, metal and gas

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4
Q

Describe von Hippel-Lindau Syndrome

A

Inherited disorder consisting of retinal angiomas and cerebellar and spinal hemangioblastomas. Cerebellar hemangioblastomas: well-circumscribed cystic lesions with enhancing mural nodule. Prone to sudden spontaneous hemorrhage. Other associations: renal cell carinoma, liver and kidney angiomas

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5
Q

Describe Sturge-Weber Syndrome

A

STURGE CAPS
S: seizures, sporadic
T: tram track gyriform calcification; trigeminal territory port-wine stain
U: unilateral weakness (hemiparesis - contralateral to facial nevus)
R: retardation
G: glaucoma, GNAQ gene
E: epilepsy

C: calvarial thickening, choroid plexus enlargement
A: atrophy of ipsilateral cerebral hemisphere
P: pial angiomatosis
S: sinus (paranasal) enlargement
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6
Q

Describe tuberous sclerosis

A

HAMARTOMAS

H: hamartomas (CNS, retinal and skin)
A: angiofibroma (facial) or adenoma sebaceum
M: mitral regurgitation
A: ash-leaf spots
R: rhabdomyoma (cardiac)
T: tubers (cortical, subcortical)
O: autOsomal dominant (autosomal sounds like starting with letter "O" )
M: mental retardation
A: angiomyolipoma (renal)
S: seizures; Shagreen patche
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7
Q

What are neurofibromatosis type 1 findings?

A

CAFE SPOT

C: café-au-lait spots (greater than six seen during one year)
A: axillary or inguinal freckling
F: fibromas (neurofibroma (two or more) or plexiform neurofibroma (one)
E: eye hamartomas (Lisch nodules)
S: skeletal abnormalities, e.g. sphenoid wing dysplasia, leg bowing
P: positive family history
OT: optic tumor (optic nerve glioma)

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8
Q

What are neurofibromatosis type 2 findings (chromosome 22)?

A

Rule of 2s
neurofibromatosis type 2
chromosome 22 (22q12) gene location
bilateral vestibular schwannomas
presents in 2nd-4th decades (around 20 years)
initial prevalence estimated to be 1:200,000, now thought ~1:25,000

MISME
    M: multiple
    I: inherited
    S: schwannomas
    M: meningiomas and
    E: ependymomas
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9
Q

Describe Dandy-Walker malformation

A

Large posterior fossa with high tentorial insertion. Dilated cysts 4th ventricle fills posterior fossa. Cerebellar vermis and hemispheres may be hypoplastic or absent.

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10
Q

Describe Chiari I malformations

A

Cerebellar tonsillar ectopia (tonsils extend > 5 mm below foramen magnum). Patients may be asymptomatic. May give rise to cervical spinal cord syrinx.

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11
Q

Describe Chiari II malformations

A

Chiari II malformations are relatively common congenital malformation of the spine and posterior fossa characterized by myelomeningocele (lumbosacral spina bifida aperta) and a small posterior fossa with descent of the brainstem and cerebellar tonsils and vermis. Numerous associated abnormalities are also frequently encountered.

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12
Q

In adults, at what level does the tip of the conus medullaris typically terminate?

A

The spinal cord is rostrally continuous with In adults, the tip of the conus typically terminates at the level of L1-L2, however it may terminate as high as mid-T12 or as low as L2-L3.

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13
Q

Where are the two enlargements of the cord?

A

The cord has two enlargements, cervical (C4-T1) and lumbosacral (T11-L1). The cervical enlargement provides innervation to the upper limbs via the brachial plexus, while the lumbosacral enlargement innervates the lower limbs via the lumbosacral plexus.

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14
Q

What are the two most common primary intramedullary tumors?

A

Astrocytoma and Ependymoma

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15
Q

What is most common neoplasm of the spine?

A

Metastases

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16
Q

What are the shared features of spinal astrocytoma and spinal ependymoma?

A

Expansile. Low T1 and high T2 signals with variable enhancement. Increased incidence in neurofibromatosis.

17
Q

What is most common spinal cord tumor in adults?

A

Ependymoma