Radiology Examples Flashcards
1
Q
45 y/o with headache.
A
Subarachnoid hemorrhage
- “Star sign”
2
Q
39 y/o F with right- sided weakness and left 6th nerve palsy.
A
Brainstem glioma
3
Q
65 y/o alcoholic with confusion. The smaller, inset image is a normal MRI for comparison.
A
Wernicke’s encephalopathy
4
Q
13 y/o with ataxia.
A
Von-Hippel-Lindau syndrome with cerebellar hemangioblastomas
5
Q
57 y/o with seizures.
A
Meningioma
6
Q
65 y/o M with rigidity.
A
Olivopontocerebellar atrophy
- Associated with multiple system atrophy (MSA)
7
Q
45 y/o M with bitemporal hemianopsia.
A
Meningioma arising from dorsum sella
8
Q
Angiograms after subarachnoid hemorrhage in different patients.
A
Vasospasm
9
Q
39 y/o M found down.
A
Intraventricular bleed due to AVM
10
Q
46 y/o M with weakness diffusely.
A
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
11
Q
36 y/o healthy M with cognitive slowing, personality changes, HIV neg.
A
Gliomatosis cerebri
- 5% of glioma cases are multicentric
12
Q
48 y/o M admitted for ETOH withdrawal, became encephalopathic and parkinsonized in hospital.
A
Central pontine and extrapontine myelinolysis
13
Q
36 y/o healthy F with left-sided weakness and numbness.
A
Primary CNS lymphoma
14
Q
89 y/o F with alexia w/o agraphia and aphasia.
A
Remote PCA and MCA stroke
15
Q
An otherwise healthy 23-year-old man presented with confusion and trouble speaking for 3 days. There was no prior trauma.
A
Herpes encephalitis
- HSV has predilection for frontal and temporal lobes
16
Q
9 y/o M with seizures- 3 MRIs in one week.
A
Admission: ganglioglioma
Day 2: Intracranial electrodes
Day 5: Temporal lobectomy
17
Q
8 y/o boy with mental retardation and seizures. He had operation.
A
Sturge-Weber syndrome
- “Tram-track” calcifications
- Underwent hemispherectomy
18
Q
59 y/o with sudden onset cortical blindness.
A
Bilateral PCA stroke
19
Q
68 y/o F with left sided visual hallucinations.
A
Hemorrhagic conversion of PCA ischemic stroke
20
Q
Immuno- compromised patient with seizure.
A
Aspergillosis
21
Q
35 y/o F with acute R-sided weakness.
A
Thrombosis of inferior sagittal sinus
22
Q
20 y/o F with psychosis.
A
Limbic encephalitis
- Limbic system
- It controls the basic emotions (fear, pleasure, anger) and drives (hunger, sex, dominance, care of offspring)
23
Q
25 y/o F with headaches.
A
Pseudotumor cerebri
- “Slit-like” ventricles
- Empty sella turcica
24
Q
65 y/o M with dementia.
A
Creutzfeldt-Jakob Disease (CJD)
- “Double hocky stick” sign
25
Headache and visual disturbance.
**Posterior reversible encephalopathy syndrome (PRES)**
* Due to **acute HTN**
26
65 y/o F s/p procedure.
**Deep brain stimulation for PD**
* Stimulation of **subthalamic nucleus**
27
44 y/o M with seizure.
**Oligodendroglioma**
* Calcifications
28
65 y/o F with headaches and ataxia.
**Metastatic disease**
29
Intractable Seizures.
**Corpus callosotomy**
30
65 y/o F with M with cranial nerve deficits and dysphagia.
**Meningioma**
31
54 y/o M with HIV, dementia and personality changes.
**PML**
32
Child with encephalopathy and seizures.
**Acute disseminated encephalomyelitis (ADEM)**
* **100% lesions enhance**
33
34 y/o F with cirrhosis and tremor.
**Wilson's disease**
* **"Panda" sign**
34
45 year-old man, found down.
**Combined MCA/PCA stroke**
35
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
36
21 y/o with many years of seizures, now headache.
**Subependymal giant cell astrocytoma (SEGA) of tuberous sclerosis**
37
2 elderly patients, acute speech and vision problems.
**Lobar bleeds in patients with amyloid**
38
41 y/o with dementia and ataxia, HIV neg., no cancer.
**Multiple sclerosis**
39
43 M s/p trauma.
**Hemorrhagic contusions of frontal/temporal lobes**
40
Patients with paraparesis and behavioral changes after"
1. Menigioma embolization and removal
2. Subarachnoid hemorrhage
**Bilateral ACA strokes**
41
7 y/o with headaches and ataxia.
**Juvenile pilocytic astrocytoma (JPA)**
42
2 middle aged patients with cranial nerve palsies.
**Giant serpentine aneurysms**
43
57 y/o with old stroke.
**Wallerian degeneration**
44
43 y/o M with stroke.
**Congenitally absent internal carotid arteries**
45
Child with mental retardation and headaches.
**Subependymal giant cell astrocytoma (SEGA) of tuberus sclerosis**
46
3 patients with variable combination of L-sided weakness, neglect, CN3 palsy.
**Uncal herniation due to tumor bleed, MCA stroke**
47
67 y/o with sudden aphasia.
**Cardioembolic stroke**
48
13 y/o M child with mild mental retardation and skin lesions.
**Neurofibromatosis type 1 and unidentified bright objects (UBOs)**
49
67 y/o with dementia.
**Bad microvascular disease**
50
36 y/o M with seizures.
**Arteriovenous malformation (AVM)**
51
2 y/o F with headaches and restricted upgaze.
**Pinealcytoma**
52
89 y/o M with dementia.
**Diffuse atrophy of Alzheimer's diease**
* Especially in medial temporal lobes
53
43 y/o with seizure.
**Oligodendroglioma**
54
Comatose patient with cerebellar mass.
**Tonsilar herniation**
55
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
56
45 y/o M with cognitive impairment, ataxia.
**Black holes, multiple sclerosis**
57
58 y/o with seizure.
**Cavernoma**
58
70 y/o M with dizziness, hoarseness, hearing loss.
**Glomus jugulare tumor**
* **"Salt and pepper" sign**
59
26 y/o F with dysphonia, facial numbness, Horner's syndrome.
**Lateral medullary stroke**
60
65 y/o F with acute headache.
**Subarachnoid hemorrhage (SAH)**
* **Nonaneurysmal perimesencephalic SAH**
61
57 y/o with old stroke.
**Hydrocephalus ex Vacuo**
62
45 y/o M with headaches- lesion has been stable for many years.
**Subependymoma**
63
65 y/o M with dementia.
**Creutzfeldt-Jakob disease (CJD) - cortical ribboning**
64
62 y/o F with sarcoid- what structures are enhancing.
**CN III + pituitary stalk**
65
45 y/o M with headaches, incidental finding.
**Mega cisterna magna**
66
34 y/o F with headache and seizures.
**Venous thrombosis**
* **Cord sign**
* **Empty delta sign**
67
Febrile, lethargic newborn.
**Group B strep meningitis**
* Pial mater enhancement
* Bilateral bifrontal subdural empyemas
68
Stroke in MRI below.
**Ulcerated carotid**
69
Comatose ICU patient.
**Central pontine myelinolysis (CPM)**
* **"Trident" sign** - due to sparing of corticospinal tracts
70
Found down.
**Global cerebral anoxia**
71
A 61 year-old woman presented with right eye pain and proptosis.
**Carotid cavernous fistula**
72
A 65 year-old man with moderate hypertension with progressive dementia.
**Amyloid angiopathy**
73
27 y/o with headache while laughing.
**Tonsilar herniation - Chiari I malformation**
* **"Peg-like tonsils"**
74
Failure to develop in 7 month- old.
**Aqueductal stenosis**
* A thin rim of neural tissue remains
75
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 (
76
3 year-old with new-onset clumsiness.
**Acute cerebellar ataxia**
77
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
78
Child with slow motor development and progressive enlargement of the skull.
**Dandy-Walker syndrome**
* Congenital brain malformation:
1. **Enlarged 4th ventricle**
2. **Agenesis of cerebellar vermis**
3. **Enlarged cisterna magna**
* Malformations of heart, face, limbs, fingers, toes
79
Child with mental retardation.
**Polymicrogyria (on the right)**
80
26 y/o with schizophrenia.
**Cavum septum pallucidum**
* Incidental finding
* Associated with schizophrenia
81
Patient with congenital paraplegia and mild mental retardation.
**Chiari II**
1. Herniation of medulla and cerebellar vermis
2. Upward herniation of cerebellum through tentorium
3. Elongation of pons and 4th ventricle
4. Tectal "beaking" due to fusion of colliculi
5. Supratentorial abnormalities such as agenesis of corpus callosum
6. Cerebellar hemispheres envelop the brainstem
82
Infant who “fell down stairs.”
**Hemorrhages in abused baby**
83
Child with mental retardation and seizures.
**Cortical malformation of left hemisphere**
84
Child with mental retardation.
**Bilateral schizencephaly**
85
23 y/o M with back stiffness.
**Ankylosing spondylitis**
* **"Bamboo spine"**
86
45 y/o M awoke unable to move legs, no enhancement with contrast.
**Spinal infarct**
87
56 y/o M with severe burning and tingling in extremities.
**Vitamin B12 deficiency - posterior column lesions**
88
5 y/o M with severe burning and tingling in extremities.
**HIV myelopathy**
89
Dorsal Column disease due to metal deficiency.
**Copper deficiency myelopathy**
90
Child with multiple fractures, blue sclera.
**Osteogenesis imperfecta**
91
2 cases of kids with pain, weakness, incontinence progressive over several years.
**Tethered cord syndrome**
