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FMS > Neuroscience Week 6: Neuroradiology of vascular diseases > Flashcards

Neuroscience Week 6: Neuroradiology of vascular diseases Flashcards

1
Q

CT displays images in gray-scale from whit to black, based on?

A

Materials density

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2
Q

Ischemic infarctions often cause brain edema resulting in what on CT?

A

increased water density which appears hypodense

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3
Q

Acute intracranial hemorrhage often appears what on CT?

A

Hyperdense

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4
Q

Identify

A
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5
Q

Epidural hemorrhage radiology

4 listed

A
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6
Q

Epidural hemorrhage common etiology

A

associated with trauma and calvarial fractures

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7
Q

Subdural hemorrhage radiology

A
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8
Q

Epidural hemorrhage cross calvarial sutures?

A

No

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9
Q

Subdural hemorrhage cross calvarial sutures?

A

May cross calvarial sutures

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10
Q

Subdural hemorrhage cross falx cerebri and tentorium cerebelli?

A

Does not cross the falx cerebri and tentorium cerebelli

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11
Q

Does epidural Hemorrhage cross the falx cerebri and tentorium cerebelli?

A

May cross the falx cerebri and tentorium cerebelli

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12
Q

Subdural hemorrhage common causes

A

associated with trauma: tearing of the bridging veins

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13
Q

Subarachnoid hemorrhage radiology

A
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14
Q

Subarachnoid hemorrhage common causes

A

associated with trauma and aneurysms

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15
Q

Aneurysmal Subarachnoid hemorrhage common locations

A

Most commonly Saccular and arise from/near the circle of Willis

  • ACOM, PCOM and MCA bifurcation
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16
Q

Aneurysm definition

A

abnormal dilation or outpouching

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17
Q

Aneurysmal Subarachnoid hemorrhage pattern: Supracellar cistern

A
  • IC
  • PCOM
  • ACOM
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18
Q

Aneurysmal Subarachnoid hemorrhage pattern: Sylvian fissure

A

MCA bifurcation

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19
Q

Aneurysmal Subarachnoid hemorrhage pattern: Prepontine cistern, cerebellopontine angle

A
  • PICA
  • Basilar tip
  • Vertebral
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20
Q

Identify

A

Aneurysmal subarachnoid hemorrhage

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21
Q

Identify

A

Aneurysmal subarachnoid hemorrhage

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22
Q

Identify

A

Aneurysmal subarachnoid hemorrhage

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23
Q

Identify

A
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24
Q

Identify

A
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25
Q

Identify

A
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26
Q

Identify

A
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27
Q

Identify

A
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28
Q

Intraparenchymal hemorrhage: Hypertensive

A
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29
Q

Intraparenchymal hemorrhage: Peripheral lobar

A
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30
Q

Intraparenchymal hemorrhage: Traumatic (blunt)

A
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31
Q

Identify

A

Intraparenchymal hemorrhage shearing injury

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32
Q

Stroke definition

A

“clinical” acute nervous system injury/focal neurologic deficit with abrupt onset

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33
Q

Infarct definition

A

Pathologic/Radiologic

  • Brain cell death attributable to ischemia based on neuropathological, neuroimaging and/or clinical evidence of permanent injury
34
Q

Hemorrhagic infarct

A

popped vessel

35
Q

Ischemic infarct

A

Blocked vessel

36
Q

Venous infarct

A

blocked or popped vein

37
Q

Transient ischemic attack

A

clinical diagnosis

temporary blocked vessel/temporary neurologic deficit (<1 hour)

38
Q

Acute ischemia accounts for what % of all stroke?

A

~80%

39
Q

Ischemic stroke scale

A
40
Q

How is imaging helpful in stroke?

A

CT, MRI: Bleed or no bleed

CT, MRI, cerebral perfusion imaging: How large is the infarction? is there salvageable brain?

CTA, MRA, catheter angiogram: is there a large vessel occlusion

41
Q

The primary goal for imaging in stroke is to?

A
  • Rapidly identify and triage patients for appropriate therapeutic intervention
  • Time = brain
  • Imaging approach dependent on resources and expertise
42
Q

Recent imaging clinical trials

A

Recent clinical trials

  • Endovascular thrombectomy in large vessel occlusions
  • Expanded time window for therapy (role for cerebral perfusion imaging)
43
Q

How is CT of head helpful?

A

bleed or no bleed

no large-volume infarction

44
Q

No intracranial hemorrhage nor large volume infarction =

A

t-PA

45
Q

How is CTA head and neck helpful?

A
  • Cardiac embolus
  • Atheromatous plaque
  • Vascular injury
  • Aneurysm
46
Q

Proximal accessible large vessel occlusion =

A

endovascular thrombectomy

47
Q

Aneurysm treatment

A

Surgical clipping or endovascular coiling

48
Q

Ischemic infarct by CT features

4 listed

A
49
Q

Ischemic infarct by MRI features

A
50
Q

Ischemic infarct evolution: Ages

A
  • Hyperacute
  • Acute
  • Subacute
  • Chronic
51
Q

Ischemic infarct evolution: CT features

A

Hyperdense artery sign is the earliest sign

Parenchymal hypodensity as early as 1 hour, up to 6 hours

  • lentiform nucleus hypodensity
  • Insular ribbon sign

Parenchymal swelling day 1-7

Volume loss and gliosis is the latest sign

52
Q

Ischemic infarct evolution: MRI features

A

DWI: Bright from 0-14 days

ADC: Dark from 0 hrs to 10 days, normalizes 10-14 days

T2 Flair: bright from 2-6 hours up to 21 days

Cortical laminar necrosis: T1 bright after 14 days, as early as 3-5 days

Parenchymal enhancement: ~5-7 days to 8 months

53
Q

Ischemic infarct evolution: Hemorrhagic transformation

A

2-5 days

54
Q

Identify

A

Left MCA infarct, insular ribbon sign 18 hours later

55
Q

Identify

A

Left MCA infarct, hyperdense MCA sign, carotid bulb thrombus

56
Q

Identify

A

Global hypoxic ischemic injury

57
Q

Identify

A

Herpes Encephalitis

58
Q

Identify

A
59
Q

Identify

A
60
Q

Identify

A
61
Q

Identify

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62
Q

Identify

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63
Q

Identify

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64
Q

Identify

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65
Q

Identify

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66
Q

Identify

A
67
Q

Identify

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68
Q

Identify

A
69
Q

Identify

A
70
Q

Identify

A
71
Q

Identify

A
72
Q

Identify

A
73
Q

Identify

A
74
Q

Homunculus

A
75
Q

Identify motor strip

A

right finger tapping

76
Q

Identify motor strip

A
77
Q

Identify area

A

Broca’s Area

78
Q

Identify area & function

A
  • Broca’s Area
  • Naming objects
79
Q

Identify Area & Function

A
  • Wernicke’s Area
  • Language comprehension
80
Q

Where is the primary visual cortex?

A

FMS (34 decks)

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