Radiology Examples Flashcards
45 y/o with headache.
Subarachnoid hemorrhage
- “Star sign”
39 y/o F with right- sided weakness and left 6th nerve palsy.
Brainstem glioma
65 y/o alcoholic with confusion. The smaller, inset image is a normal MRI for comparison.
Wernicke’s encephalopathy
13 y/o with ataxia.
Von-Hippel-Lindau syndrome with cerebellar hemangioblastomas
57 y/o with seizures.
Meningioma
65 y/o M with rigidity.
Olivopontocerebellar atrophy
- Associated with multiple system atrophy (MSA)
45 y/o M with bitemporal hemianopsia.
Meningioma arising from dorsum sella
Angiograms after subarachnoid hemorrhage in different patients.
Vasospasm
39 y/o M found down.
Intraventricular bleed due to AVM
46 y/o M with weakness diffusely.
Amyotrophic lateral sclerosis
- Hyperintensity of corticospinal tract
-
Cotricospinal tract
- Primary motor cortex → posterior limb of internal capsule → cerebral peduncle → pons → lower medulla (pyramids) → decussates! → spinal cord → anterior horn (synapse) → exits ventral horn
36 y/o healthy M with cognitive slowing, personality changes, HIV neg.
Gliomatosis cerebri
- 5% of glioma cases are multicentric
48 y/o M admitted for ETOH withdrawal, became encephalopathic and parkinsonized in hospital.
Central pontine and extrapontine myelinolysis
36 y/o healthy F with left-sided weakness and numbness.
Primary CNS lymphoma
89 y/o F with alexia w/o agraphia and aphasia.
Remote PCA and MCA stroke
An otherwise healthy 23-year-old man presented with confusion and trouble speaking for 3 days. There was no prior trauma.
Herpes encephalitis
- HSV has predilection for frontal and temporal lobes
9 y/o M with seizures- 3 MRIs in one week.
Admission: ganglioglioma
Day 2: Intracranial electrodes
Day 5: Temporal lobectomy
8 y/o boy with mental retardation and seizures. He had operation.
Sturge-Weber syndrome
- “Tram-track” calcifications
- Underwent hemispherectomy
59 y/o with sudden onset cortical blindness.
Bilateral PCA stroke
68 y/o F with left sided visual hallucinations.
Hemorrhagic conversion of PCA ischemic stroke
Immuno- compromised patient with seizure.
Aspergillosis
35 y/o F with acute R-sided weakness.
Thrombosis of inferior sagittal sinus
20 y/o F with psychosis.
Limbic encephalitis
- Limbic system
- It controls the basic emotions (fear, pleasure, anger) and drives (hunger, sex, dominance, care of offspring)
25 y/o F with headaches.
Pseudotumor cerebri
- “Slit-like” ventricles
- Empty sella turcica
65 y/o M with dementia.
Creutzfeldt-Jakob Disease (CJD)
- “Double hocky stick” sign
Headache and visual disturbance.
Posterior reversible encephalopathy syndrome (PRES)
- Due to acute HTN
65 y/o F s/p procedure.
Deep brain stimulation for PD
- Stimulation of subthalamic nucleus
44 y/o M with seizure.
Oligodendroglioma
- Calcifications
65 y/o F with headaches and ataxia.
Metastatic disease
Intractable Seizures.
Corpus callosotomy
65 y/o F with M with cranial nerve deficits and dysphagia.
Meningioma
54 y/o M with HIV, dementia and personality changes.
PML
Child with encephalopathy and seizures.
Acute disseminated encephalomyelitis (ADEM)
- 100% lesions enhance
34 y/o F with cirrhosis and tremor.
Wilson’s disease
- “Panda” sign
45 year-old man, found down.
Combined MCA/PCA stroke
12 y/o with headaches.
Developmental venous anomoly (DVA) blocking cerebral aqueduct with significant hydrocephalus
- DVA
- Enlarged venous vessels that drain into a large-caliber vein with a characteristic appearance of caput medusa on angiography
21 y/o with many years of seizures, now headache.
Subependymal giant cell astrocytoma (SEGA) of tuberous sclerosis
2 elderly patients, acute speech and vision problems.
Lobar bleeds in patients with amyloid
41 y/o with dementia and ataxia, HIV neg., no cancer.
Multiple sclerosis
43 M s/p trauma.
Hemorrhagic contusions of frontal/temporal lobes
Patients with paraparesis and behavioral changes after”
- Menigioma embolization and removal
- Subarachnoid hemorrhage
Bilateral ACA strokes
7 y/o with headaches and ataxia.
Juvenile pilocytic astrocytoma (JPA)
2 middle aged patients with cranial nerve palsies.
Giant serpentine aneurysms
57 y/o with old stroke.
Wallerian degeneration
43 y/o M with stroke.
Congenitally absent internal carotid arteries
Child with mental retardation and headaches.
Subependymal giant cell astrocytoma (SEGA) of tuberus sclerosis
3 patients with variable combination of L-sided weakness, neglect, CN3 palsy.
Uncal herniation due to tumor bleed, MCA stroke
67 y/o with sudden aphasia.
Cardioembolic stroke
13 y/o M child with mild mental retardation and skin lesions.
Neurofibromatosis type 1 and unidentified bright objects (UBOs)
67 y/o with dementia.
Bad microvascular disease
36 y/o M with seizures.
Arteriovenous malformation (AVM)
2 y/o F with headaches and restricted upgaze.
Pinealcytoma
89 y/o M with dementia.
Diffuse atrophy of Alzheimer’s diease
- Especially in medial temporal lobes
43 y/o with seizure.
Oligodendroglioma
Comatose patient with cerebellar mass.
Tonsilar herniation
Left-sided weakness and neglect. Obviously a tumor, what else is being show.
Subfalcine (cingulate) herniation
- Branches of ACA may be compressed, leading to infarction
45 y/o M with cognitive impairment, ataxia.
Black holes, multiple sclerosis
58 y/o with seizure.
Cavernoma
70 y/o M with dizziness, hoarseness, hearing loss.
Glomus jugulare tumor
- “Salt and pepper” sign
26 y/o F with dysphonia, facial numbness, Horner’s syndrome.
Lateral medullary stroke
65 y/o F with acute headache.
Subarachnoid hemorrhage (SAH)
- Nonaneurysmal perimesencephalic SAH
57 y/o with old stroke.
Hydrocephalus ex Vacuo
45 y/o M with headaches- lesion has been stable for many years.
Subependymoma
65 y/o M with dementia.
Creutzfeldt-Jakob disease (CJD) - cortical ribboning
62 y/o F with sarcoid- what structures are enhancing.
CN III + pituitary stalk
45 y/o M with headaches, incidental finding.
Mega cisterna magna
34 y/o F with headache and seizures.
Venous thrombosis
- Cord sign
- Empty delta sign
Febrile, lethargic newborn.
Group B strep meningitis
- Pial mater enhancement
- Bilateral bifrontal subdural empyemas
Stroke in MRI below.
Ulcerated carotid
Comatose ICU patient.
Central pontine myelinolysis (CPM)
- “Trident” sign - due to sparing of corticospinal tracts
Found down.
Global cerebral anoxia
A 61 year-old woman presented with right eye pain and proptosis.
Carotid cavernous fistula
A 65 year-old man with moderate hypertension with progressive dementia.
Amyloid angiopathy
27 y/o with headache while laughing.
Tonsilar herniation - Chiari I malformation
- “Peg-like tonsils”
Failure to develop in 7 month- old.
Aqueductal stenosis
- A thin rim of neural tissue remains
Premature baby, initial ultrasound and f/u scans.
Germinal matrix hemorrhage (grade IV), porencephalic cyst
- The germinal matrix contains a rich network of fragile thin-walled blood vessels. Hence the microcirculation in this particular area is extremely sensitive to hypoxia and changes in perfusion pressure.
- It is most frequent before 35 weeks gestationand is typically seen in very low birth-weight (
3 year-old with new-onset clumsiness.
Acute cerebellar ataxia
Child with marked mental retardation, intractable epilepsy, and severe cerebral palsy.
Lissencephaly
- Smooth cortical surface except for rudimentary sulci in the parietal, frontal, or whole brain
Child with slow motor development and progressive enlargement of the skull.
Dandy-Walker syndrome
- Congenital brain malformation:
- Enlarged 4th ventricle
- Agenesis of cerebellar vermis
- Enlarged cisterna magna
- Malformations of heart, face, limbs, fingers, toes
Child with mental retardation.
Polymicrogyria (on the right)
26 y/o with schizophrenia.
Cavum septum pallucidum
- Incidental finding
- Associated with schizophrenia
Patient with congenital paraplegia and mild mental retardation.
Chiari II
- Herniation of medulla and cerebellar vermis
- Upward herniation of cerebellum through tentorium
- Elongation of pons and 4th ventricle
- Tectal “beaking” due to fusion of colliculi
- Supratentorial abnormalities such as agenesis of corpus callosum
- Cerebellar hemispheres envelop the brainstem
Infant who “fell down stairs.”
Hemorrhages in abused baby
Child with mental retardation and seizures.
Cortical malformation of left hemisphere
Child with mental retardation.
Bilateral schizencephaly
23 y/o M with back stiffness.
Ankylosing spondylitis
- “Bamboo spine”
45 y/o M awoke unable to move legs, no enhancement with contrast.
Spinal infarct
56 y/o M with severe burning and tingling in extremities.
Vitamin B12 deficiency - posterior column lesions
5 y/o M with severe burning and tingling in extremities.
HIV myelopathy
Dorsal Column disease due to metal deficiency.
Copper deficiency myelopathy
Child with multiple fractures, blue sclera.
Osteogenesis imperfecta
2 cases of kids with pain, weakness, incontinence progressive over several years.
Tethered cord syndrome
