NEURORADIOLOGY Flashcards
Which among the following is NOT a primary effect of CNS trauma?
a. Cerebral edema
b. Subarachnoid hemorrhage
c. Skull fractures
d. Cephalhematomas
Cerebral edema
What is the most common brain herniation that causes secondary cerebral infarction?
Descending transtentorial herniation
Which of the following does NOT describe a second-impact syndrome?
a. It is a more acute catastrophic complication of repetitive head injury.
b. In most cases, a small subdural hematoma is associated with disproportionately large brain swelling.
c. NECT scans may show small crescent-shaped, hyper- or mixed density subdural hemorrhage overlyuing a swollen, hypodense cerebral hemisphere.
d. Complete ascending herniation with brainstem compression occurs.
d. Complete ascending herniation with brainstem compression occurs.
What is the most common cause of spontaneous intracerebral hemorrhage in young adults?
Vascular malformation
Where is the most common location of hypertensive intracranial hemorrhage (Osborn, 2nd edition)?
Putamen
What is the modified Fisher CT grading for >1 mm thick subarachnoid hemorrhages, with intraventricular hemorrhage or parenchymal hemorrhage?
Grade 4
What is the modified Fisher CT grading for >1 mm thick subarachnoid hemorrhages, with intraventricular hemorrhage or parenchymal hemorrhage?
Grade 4
Grade 1- thin WITHOUT IVH
GRADE 2- thin WITH IVH
grade 3- thick WITHOUT IVH
Which of the following is TRUE regarding nontraumatic subarachnoid hemorrhages?
a. Aneurysmal: widespread; basal cisterns
b. Non-aneurysmal: clinically benign; complications and recurrence rare.
c. Aneurysmal: arterial in origin
d. All of the above are true.
d. All of the above are true.
Which of the following does NOT describe classical superficial siderosis?
a. Posterior fossa than supratentorial.
b. Due to chronic repeated subarachnoid hemorrhages.
c. Sensorineural hearing loss is common.
d. Most common etiology is amyloid angiopathy.
d. Most common etiology is amyloid angiopathy
Where is the most common location of the saccular aneurysm?
Anterior communicating arteries
Which of the following does NOT increase the risk of rupture of saccular aneurysm?
b. > 3 mm in size
c. Non-round/non-saccular
d. Daughter sac
e. ICA/PCoA location
b. > 3 mm in size
What is the most SPECIFIC BUT least SENSITIVE sign of acute infarction?
Dense MCA SIGN
Dot sign - MCA BRANCHES IN THE Sylvian fissure
Insular ribbon sign- loss of insular cortex
Disappearing basal ganglia sign- decrease density of the basal ganglia
Which of the statement is in CORRECT? Osborn 215
a. Ischemic penumbra is seen as mismatch between markedly reduced CBV in the infarcted core.
b. Potentially salvageable brain tissue is equivalent to CBV minus CBF.
c. Prolonged MTT over 145% that extends beyond the core infarct area characterize ischemic penumbra.
d. Infarct core shows mismatched between CBV and CBF.
d. Infarct core shows mismatched between CBV and CBF.
Which of the following imaging findings is seen NOT seen in acute infarction?
a. Hyperdense vessel in NECT.
b. Enhancing vessels in CECT.
c. T1WI is usually hypointense in first 4-6 hours.
d. Hyperintense in DWI
c. T1WI is usually hypointense in first 4-6 hours.
What is the most common type of watershed infarct?
External watershed zone
Which of the following describes posterior reversible encephalopathy syndrome?
a. Typically involves basal ganglia, thalami, and pons.
b. Occur in the setting of acute hypertension.
c. Restricts on DWI.
d. Randomly scattered.
b. Occur in the setting of acute hypertension.
. A patient presented with an infarct in the bilateral medial thalami, just lateral to the third ventricle. On NECT, is demonstrates hypodense areas in both thalami extending into the central midbrain. Which of the following is the expected culprit vessel?
Artery of Percheron
What is the state hemoglobin state of brain hemorrhage when it is both hyperintense in T1W and T2W signals?
Methemoglobin
Which of the following herniations is most commonly associated with Duret hemorrhage?
Descending transtentorial herniation
What is the most common non-traumatic cause of spontaneous intraventricular hemorrhage in neonate >24 weeks of gestation?
Dural venous sinus thrombosis
Which among the following is the most common non-hemorrhagic cause of blooming dots in T2*?
Pneumocephalus
What is the most likely cause of immediate cerebral ischemia after aneurysmal rupture?
Vasoconstriction
What is the Cognard classification of dural AVF characterized by spinal perimedullary venous drainage?
Grade/Type 5
type I
confined to sinus
antegrade flow
no cortical venous drainage/reflux
type II
IIa
confined to sinus
retrograde flow (reflux) into sinus
no cortical venous drainage/reflux
IIb
drains into sinus with reflux into cortical veins
antegrade flow
IIa+b
drains into sinus with reflux into cortical veins
RETROgrade flow
type III
drains directly into cortical veins (not into sinus) drainage (40% hemorrhage)
type IV
drains directly into cortical veins (not into sinus) drainage with venous ectasia (65% hemorrhage)
type V
spinal perimedullary venous drainage, associated with progressive myelopathy
What is the only cranial nerve that lies inside the cavernous sinus?
CN VI
The densely ischemic penumbra will show matched reduction in both CBV and CBF with prolonged MTT on perfusion CT. True or False?
FALSE —- densely INFARCT CORE
Which of the following statements about intracranial germ cell tumor is FALSE?
a. Homologs of gonadal neoplasms
b. Propensity to arise in the periphery
c. Often restricts on DWI
d. Appears hyperdense and engulfs pineal calcification
b. Propensity to arise in the periphery
Part of the CORPUS STRIATUM includes the CAUDATE NUCELUS and?
a. Globus pallidus
b. Putamen
c. Internal capsule
d. Thalamus
Putamen
The combination o fthe globus palidus medially and putamen laterally is referred to as:
a. Corpus Striatum
b. Lentiform Nucleus
c. Red Nucleus
d. None of the above
Lentiform Nucleus
Osborn:
MCC sICH in newborn and infants
<34 wks AOG: Germinal Matrix Hge
>34 wks AOG: Dural Venous Sinus Thrombosis
Osborn:
MCC sICH in children
Vascular Malformation
Osborn:
MCC of MULTIPLE sponataneous ICH in CHILDREND and YOUNG ADULT
Multiple Cavernoma
Osborn:
MCC of MULTIPLE spontaneous ICH in MIDDLE and OLDER ADULTs
Chronic hypertension
Amyloid angiopathy
Osborn:
MCC of MULTIPLE spontaneous ICH in ALL AGES
Dural Venous Sinus Thrombosis
Cortical Vein Occlusion
Osborn:
MCC of blooming black dots on T2
Pneumocephalus
Histologic appearance of neurons in the 1st 8-12 h of infarction
Normal
Histologic appearance of neurons in the 1st 12-24 h of infarction
Red and Dead w/
Hyperesosinophillic cytoplasm
Pyknotic nuclei
Early karyolysis
Heirarchy of most susceptible cerebral cells during infarction
Descending order
N eurons (most susceptible)
A strocytes
O ligodendrocytes
M icroglia
E ndothelial cells
Osborn:
Most specific but less sensitive sign of acute cerebral infarction
D2nse MCA sign (M1)
Osborn:
MCC of acute febrile encephalopathy
Pyogenic meningitis
Osbirn:
Modality of choice for the evaluation of brain abscess
Cranial MRI
Osborn:
MC pathogen to cause ventriculitis
Staph
Strep
Enterobacter
Osborn:
MC inciting event of CNS empyema in infants and young children
Bacterial meningitis
Osborn:
MC inciting event of CNS empyema in older children and adults
Paranasal disease
20% due to otomastoiditis
Osborn:
MC pathogen of CNS empyema
Staph
Strep
Osborn:
MC location of CNS empyema
SUBdural Space; frontal and frontoparietal convexity
Osborn:
POTT PUFFY Tumor - a flactuant (doughy) tender erythematous swelling of tyebfrontal scalp is a specific sign of what disease
Frontal bone osteomyelitis w/ subperiosteal abscess
