neurorradiology Flashcards
CT’s best indication
- acute bleeds
- skulls fractures
MRI’s best sequence and indication
T1- anatomy (white matter) T2 FLAIR: pathology (white matter shows as dark) T1 with contrast: tumors DWI: strokes DTI: TBI PET (FDG or amyloid): dementia
CO and manganese poisoning - Imaging
bilateral hyper intensities of globus pallidus and nonspecific white matter changes
What is DaTscan and when is it used?
It is a type of SPECT that labels dopamine
Only ind is to support dx of Parkinsonism
PET scan - common uses
- dx of dementias
Vascular lesion on ACA
- what structures?
- what symptoms will it cause?
- anterior corpus callosum -> transcortical aphasia, callosal apraxia
- anterior cingulate -> transient akinetic mutism (can mimic catatonia)**
Vascular lesion on MCA
- what symptoms will it cause?
- Broca’s aphasia (L) /aprosodia (R)
- global aphasia (L)/aprosodia (R)
- conduction aphasia
- Alexia with agraphia
- post sup temporal -> wernicke’s aphasia (L)/receptive aprosodia (R)
- R parietal -> unilateral neglect, anosognosia
Vascular lesion on PCA
- what structures?
- what symptoms will it cause?
- hippocampus -> verbal vs nonverbal amnesia
- occipital cortex - hemianopsia, VH
- calcarine -> hemianopsia, achromatopsia
- cerebral peduncle -> peduncular hallucinations
Billateral PCA lesion can cause global amnesia, cortical blindness, or Anton’s synd
Vascular lesion on basilar artery
- what structures?
- what symptoms will it cause?
- Midbrain
- Top of basilar synd, VH
Vascular lesion on basilar artery’s penetrating branches
- what structures?
- what symptoms will it cause?
- base of pons -> locked in synd
- part of thalamus -> memory, perseveration, executive dysfunction, disinhibition
- lobus pallidus, nucleus accumbens -> apathy
Huntington’s disease
Caudate atrophy
Wilson’s disease
T2 signal diffuse basal ganglia and brain stem
Limbic encephalitis
increased T2 signal medial temporal regions, mostly bilateral
Wernicke-Korsakoff synd
decrease size and increased T2 signal of maxillary bodies
Creutzfeldt-Jacob disease
T2 or DWI signal bilateral putamen and head of caudate and deep cortical structures
Lesion on orbitofrontal region or anterior thalamus
- disinhibition
- emotional lability
- impulsive
- lack of empathy
Lesion on dorsolateral frontal cortex
- memory
- executive function
- perseveration
- planning
Lesion on anterior cingulate
Akinetic mutism, apathy
Lesion on medial temporal or medial thalamus
memory
Lesion on amygdala
- loss of anger and fear
- hypersexuality
Lesion on fusiform cortex
facial recognition
schizophrenia
- enlarged lateral ventricles on MRI**
- reduced gray matter in prefrontal, cingulate, temporal cortices
- hypoactivity in certain PFC regions
- increased subcortical dopamine synthesis capacity
ASD
- larger brain volume at birth or abnormal increase in size in first year of life
ADHD
- smaller brain volume
