RITE Images 2003 Flashcards
Axonal spheroids in diffuse axonal injury
“shear injury” -> immediately unconscious w/ trauma à chronic closed head injury
Pituitary adenoma
- Not MEGS*
- Meningioma ependymoma glioma Schwannoma*
Which cranial nerve would be involved?
Bony erosion involving the stylomastoid foramen -> CN7 involved
Cystic astrocytoma
FTD
Schwannoma of the vestibular branch of the 8th cranial nerve
14&6 Hz positive spikes best seen in referential montage
Seen in adolescents in the posterior regions during light sleep
Wilson’s
High signal intensity in Thalamus & Putamen
Cerebellar cystic hemangioblastoma
Subacute SDH w/ mass effect on ventricles -> surgery
Colloid cyst
NCS with temporal dispersion, conduction block, and slow conduction -> CIDP
AVM
Can do amytal test and intravascular embolization to make surgery & radiation therapy more effective
Arachnoid cyst
Patient presents with cluster headache -> breath oxygen rich mixture if HA were to return
Do not need to drain or decompress arachnoid cyst b/c there’s no mass effect
neurosarcoidosis
Congenital retinoblastoma
Pineal gland shouldn’t be calcified until age 2 -> pineoblastoma
ALS - Degeneration of the corticospinal tracts
Thrombosed superior saggital sinus
Intracranial hypotension secondary to persistent CSF leak
Epidural metastasis
Bone & inner table shows irregularity & infiltration of tumor into the epidural space (metastatic prostate CA)
Sleep spindles generated in the reticular thalamic nucleus
Trichinella organism acquired by ingestion of undercooked pork
Chiari malformation w/ syringomyelia
Can get hydrocephalus due to cerebellar tonsils protruding into the foramen magnum
Cryptococcus infection
No flow in basilar artery
Germinal matrix hemorrhage – complication of premature birth
Germinal matrix = located in walls of lateral ventricles – very vascular & delicate
4 subtypes
- I – localized to germinal matrix
- II – ruptured into ventricle w/o ventricular dilation
- III – ruptured into ventricle WITH ventricular dilation
- IV – ruptured into ventricle AND cerebral parenchyma
2 T2 images scanned 6 months apart
abnormal signal in GP & white matter disease adjacent to trigone of R lateral ventricle; cerebral atrophy & enlarged CSF spaces; ventricular & subarachnoid spaces have increased -> parenchymal tissue loss
Anoxic injury in GP –
If GP affected -> CHAMWA
Canavan’s & Krabbe’s – white matter lesions!
B symmetric, parasagittal, cortical & BG venous infarctions due to thrombosis of superior sagittal sinus & deep cerebral veins
Methotrexate neurotoxicity – multiple PERIVENTRICULAR discrete or confluent foci of necrosis in cerebral or spinal white matter
Tethered cord syndrome –
Pts w/
back pain,
thickened filum terminale,
widened SC,
Posterior lipoma
Low lying SC
Axial L1/L2 should only show you filum terminale & not cord
PICA infarct – occlusion of vertebral artery
Rosenthal fibers – Alexander’s Disease
Onion bulbs – demyelination & remyelination
Seen in:
CMT
CIDP
Dejerine Sottas
Refsum
Gray Matter heterotopia or heterotopic gray matter
Aspergillosis -> hemorrhagic infarcts
Dandy Walker Malformation
No vermis
No posterior corpus callosum
Large posterior fossa cyst
No inferior vermis & hypoplasia of 2 cerebellar hemispheres
Tabes Dorsalis
Paraneoplastic Panel
Vit E deficiency
Cu deficiency
Canavan’s – U-fibers not spared
Colloid cyst
Cryptococcus – multiple bubbly cysts in white matter, caudate, & putamen
NF1
Subdural empyema
Caudate – chorea
STN -> hemiballismus
SN -> PD
Atrophic cerebellar vermis & loss of both Purkinje & Granule cell neurons -> alcoholic cerebellar degeneration
Clivus chordoma – arise from embryonic notochord (mesodermal derivative)
3rd & 4th decades; extrapontine lesion
Cartilaginous tumors – 20-60YO; extradural, arise adjacent to body of sphenoid bone;
Hamartoma in tuber cineureum - *pt would have precocious puberty
Cavum septum pellucidum & cavum vergae
lipoma
ventriculitis
MRI is effective in demonstrating a displaced optic chiasm b/c it’s mo
Lateral Geniculate Nucleus (LGN)
oligodendroglioma
Cyclopia - holoprosencephaly
stroke
NPH
Tissue resected from intraventricular mass
Tuberous sclerosis
abundant eosinophilic cytoplasm w/ prominent single nucleoli – subependymal giant cell astrocytomas – SEGA!
Healed toxoplasmosis – multiple calcified lesions seen in brain parenchyma, & cerebellum @ G/W junction – AIDS
AIDS patients have generalized atrophy
*Sarcoidosis – calcification is NOT a feature
Sturge-Weber – intracranial calcification 2ndary to pial angiomatosis w/ curvilinear calcification following contour of cortex typically in occipital / parieto-occipital lobe*
- Hyperparathyroidism – B symmetric BG calcification, dentate nuclei of cerebellum & periventricular white matter*
- Tuberous sclerosis – subependymal tubers lining ventricles*
Flaky keratin – epidermoid/dermoid
Neuritic plaques!
GBM! Poorly circumscribed variegated mass w/ foci of necrosis & hemorrhage
NOT infarct, abscess, meningioma or Huntington’s
What is disease?
Clinical presentation?
Treatment?
Tolosa-Hunt syndrome – enhancing lesion in cavernous sinus
Idiopathic noncaseating granulomatous inflammation in the cavernous sinus;
Acute painful ophthalmoplegia, progression over days to weeks, CN 3 & 6 involved; 4 & V1 in 1/3
Optic nerve 20%, V2 10%; may have elevated ESR & SLE; recurring attacks over months to eyars
Tx: high dose prednisone
Small pons & cerebellar atrophy, & olive atrophy – cerebellar pontine olivary atrophy – look for loss of belly of pons!
Severe pontine atrophy – olivopontocerebellar atrophy – part of MSA; alpha synuclein
Schizencephaly w/ septo optic dysplasia – cavity lined w/ gray matter
Porencephalic cyst – cavity would be lined w/ white matter
Tumor seeding – sagittal MR post gad who multiple round enhancing lesions on surface of spinal cord & dorsal aspect of upper thoracic cord
Cord contusions would have high signal intensity w/in the cord
Hemosiderin from prior repeated SAH
Centronuclear myopathy
Type I myofiber predominance
Substantia nigra –
Damage to one SN -> hemi parkinsonism contralateral to lesion
Indusium griseum
Coronal section of CC & cingulate gyri
Indusium – direct continuation of hippocampal formation
Thrombosed aneurysm
Ill defined ring enhancement w/ edema -> malignant brain neoplasm
Arnold Chiari Malformation – herniation of cerebellar vermis & medulla
kinking of upper cervical cord
beaking of quadrigeminal plate
Anatomical variant of both ACA originating from LICA
RPCA originates from anterior circulation – (fetal origin)
Negri body – eosinophilic intracytoplasmic inclusion in cortical neuron; seen in rabies
Leigh’s disease – abnormal signal in brain stem & BG symmetric
-see metabolic acidosis & elevated lactate
Ependymoma – b/c tumor arises from spinal canal & molds the vertebral bodies
Chordoma – arise FROM vertebral bodies or scrum
Caudate atrophy
Meningioma
Non contrast CT on L -> isointense extra-axial mass
Contrast enhancement is homogeneous & intense
Dissection – flame shaped “stump” of ICA
What is E?
E – superior medullary velum
thin, transparent lamina of white matter, which stretches between the superior cerebellar peduncles
It forms, together with the superior cerebellar peduncle, the roof of the upper part of the fourth ventricle
Quadrantic sectoranopia –
stroke in the LGN
Anterior choroidal artery involved
