Neurorradiologia

Question 1

Quando é uma restrição a difusão verdadeira?

Answer 1

Hiposinal no ADC

Question 2

CLOCCs in image looks like:

Answer 2

Cytotoxic edema

Question 3

Pattern of CLOCCs in MRI

Answer 3

Well-circumscribed, small, oval lesions in the midline within the substance of the splenium (most common)
More extensive less well-defined irregular lesions extending throughout the splenium and into the adjacent hemispheres (boomerang sign)
More extensive extension anteriorly into the body of the corpus callosum
The smaller well-circumscribed lesions are the typical lesion seen in the setting of seizures/cessation of antiseizure medications, whereas the larger lesion is more typical of other etiologies.

Question 4

Cytotoxic edema in MRI

Answer 4

T1: hypointense
T2: hyperintense
DWI/ADC: restricted diffusion
T1 C+ (Gd): no enhancement

Question 5

How long does cytotoxic edema lasts in MRI?

Answer 5

1 month, mostly within 1 week following the neurological recovery

Question 6

DD of CLOCCs

Answer 6

multiple sclerosis (MS)
acute disseminated encephalomyelitis (ADEM)
infarction (e.g. pericallosal artery occlusion)
posterior reversible encephalopathy syndrome (PRES)
trauma (e.g. diffuse axonal injury)
tumors (e.g. diffuse glioma, lymphoma)
Marchiafava-Bignami disease
cerebral fat embolism