RITE Images 2005 Flashcards
Adamantinous craniopharyngioma; “wet” keratin
Healed toxoplasmosis – multiple calcified lesions in brain B cerebral hemispheres & cerebellum @ G/W junction; AIDS pt
X-linked adrenoleukodystrophy
Lesion involving the vascular territory of the anterior (superior) branches of the MCA
Cytotoxic edema -> vasogenic edema
Ulegyria / cortical necrosis w/ gliosis @ depth of the sulci
Seen in perinatal hypoxic ischemic encephalopathy –
Pt w/ clumsy hands that worsened w/ age
MLD metachromatic leukodystrophy – white matter demyelination that spares subcortical U-fibers
Tabes dorsalis
Lafora body – myoclonic epilepsy
Graves ophthalmopathy – MRI shows enlarged EOM
Colloid cyst of 3rd ventricle
Subependymal giant cell astrocytoma – can be seen in Tuberous Sclerosis
SDH -> no need for further testing à craniotomy
Cyclopia – alobar holoprosencephaly
Cyclopia occurs w/ midline cleavage defects & clefting of the lip or the palate is usually also present
Hypertensive hemorrhage
Benign rolandic epilepsy
Germinoma – most common pineal region tumor
Colloid cyst
Mammilary bodies congested & discolored -> thiamine deficiency
Wernicke’s encephalopathy
Loculated encapsulated epidural abscess
Sagittal T1 show loculated fluic collection in posterior epidural space extending several levels in mid thoracic spine; SAS compressed à epidural space
Locus ceruleus -> NE
NCS - Temporal dispersion, Conduction block & slow conduction -> CIDP
Epidural hematoma
Heterotopic gray matter
MS
ALS - corticospinal tracts &
Initial positivity is the onset latency for terminal conduction velocity measures
DNET – dysembryoplastic neuroepithelial tumor -> do surgery
B necrosis of GP -> Carbon Monoxide Intoxication
Hemorrhage in brain stem, temporal lobes & cerebellar vermis
Intracranial hypotension 2ndary to persistent cerbrospinal fluid leak - meningeal enhancement
Germinal matrix Hemorrhage – complication of premature birth
I – localized to germinal matrix only
II – ruptured into ventricle
III – “ + ventircular dilatation
IV – “ ruptured into ventricular system & cerebral parenchyma
GBM – CLOSED RING of enhancement
Negri bodies – intracytoplasmic inclusions
Seen in Rabies
Child w/ CHF -> venous great vein of galen aneurysm
Herniated disc
Tumors that can affect pituitary- glioma
Porencephalic cyst
Complicated atherosclerosis b/c of plaque ulcerations
Neuritic plaques – histologic criteria for making dx of AD
Meningioma – intradural extramedullary mass
Ependymoma, astrocytoma & hemangioblastoma are INTRAmedullary lesions
Toxoplasmosis – lots of edema out of proportion to lesion size
w/ contrast -> see ring enhancement
What clinical finding would you expect?
Lesion in CN4 -> superior oblique weakness -> diplopia
Dandy Walker Malformation –
Enlarged posterior fossa
Missing vermis, 4th ventricle connecting w/ cisterna magna
Anterior chiasm lesion - Optic nerve lesion extending posteriorly to involve the anterior chiasm - temporal field defect in contralateral eye
Clivus chordoma – mixed signal destructive mass invovling the clivus & nasopharynx
3rd & 4th decades
Males > Females
Extradural
>1/2 arise in or adjacent to body of sphenoid bone
Anoxic injury of GP (see repeat image on R w/ bright GP)
Cerebral atrophy & enlarged CSF spaces
“CHAMWA”– carbon monoxide poisoning, hypoglycemia, AIDS, Meningitis, Wilson’s
Thrombosis of superior sagittal sinus & deep cerebral veins
B nearly symmetric, parasagittal, cortical & BG venous infarctions
Balo’s concentric sclerosis – OPEN ring -> demyelinating d/o
demyelinated tissues form concentric layers
Mural nodule - cystic astrocytoma
**If in cord or posterior fossa -> hemangioblastoma
Oligodendroglioma
30’s – 40’s – seizures
If smoker w/ lung mass -> metastatic lung CA
Male w/ posterior fossa -> medulloblastoma
TEAM CHAOS
Pituitary adenoma
Leigh’s disease – bright symmetric BG & brain stem
String of beads – Fibromuscular Dysplasia (FMD)
1/3 assoc w/ aneurysms
Hamartoma in tuber cinereum
Pt w/ precocious puberty
Neurofibrillary tangles – intraneuronal intracytoplasmic inclusion composed of paired helical filaments
Can be seen in Pick, PSP, Down’s, Parkinson dementia complex of Guam, post-encephalitic Parkinsonism
Subacute AIDS – diffuse high signal intensity throughout all of the white matter
Perivascular pseudorosettes - ependymoma
Thrombosed superior sagittal sinus – flow void
Signal intensity of the thrombus over time has the same evolution pattern as intracerebral hematomas
Aspergillosis - -> can lead to hemorrhagic infarctions
Axonal spheroids – “shear injury” – pts are rendered immediately unconscious w/ trauma ->chronic “closed head injury”
Chari I malformation
No MCA trunk
polymicrogyria
Toxoplasmosis – tachyzoites & cysts containing bradyzoites
Agenesis of corpus callosum
Severe multicystic encephalomalacia due to intrauterine hypoxia/ischemia – formation of cysts reflects cavitation which is the end stage of maturation of infarcts
HSV – encephalomalacia in B temporal lobes
L has cystic change & tissue loss
wedge shaped area of dorsolateral portion of medulla -> PICA infarct; occlusion of vertebral artery
MS
Wilson’s disease – putamen & thalami
Sleep spindles – thought to be generated by the reticular thalamic nucleus
Centronuclear myopathy
Pompe’s disease – acid maltase deficiency
Severe vacuolar myopathy due to extensive glycogen storage
B medial temporal cortical dysplasia
Schizencephaly w/ septo optic dysplasia
Not porencephalic cyst b/c this would be lined by white matter NOT gray matter as shown here
B frontal contusions w/ slight orange tinge 2ndary to presence of residual hemosiderin-laden macrophages
Olfactory nerves jacked -> anosmia
aneurysm
Anterior cavum septum pellucidum
Periventricular areas of demyelination -> MS
Flaky keratin -> epidermoid cysts
GBM – closed ring w/ enhancement
Abnormal hyperintensity filling the vein of Galen & straight sinus (instead of normal flow void expected) ->
thrombus in vein of Galen & straight sinus ->
hemorrhagic venous infarction in thalami
Canavan’s disease
- MLD – spares U-fibers*
- Adrenoleukodystroph – occipital & parietal regions*
Ragged Red Fibers
Kearns-Sayre myopathy
Which CN would be affected?
CN 7 would be affected b/c of erosion to stylomastoid foramen
Gliomatous infiltration of leptomeninges; leptomeningeal carcinomatosis?
Cystic hemangioblastoma
Cystic cerebellar hemispheric mass w/ enhancing mural nodule
Myokymic discharges
Can be associated w/ potassium channel antibodies
Methemoglobin – containing subacute clot in subdural space
C4-C5 most narrow portion of the cervical canal in this image
Cavernous angioma
CJD – spongiform changes
Mild to no atrophy of hippocampus
- *Friedreich’s ataxia** –
- *posterior columns & spinocerebellar tracts**
Cardiomyopathy + adult onset of DM
Dentatorubral – palliduloysian atrophy – thickening of skull
Gynecomastia & testicular atrophy – spinal & bulbar muscular atrophy
“tufted astrocytes” -> seen in PSP
(also see globoid neurofibrillary tangle)
Globoid neurofibrillary tangle – seen in SN, brainstem tegmentum, putamen, & select cortical areas
-> seen in PSP
(also see tufted astrocytes)
Kernicterus – infants who die w/ severe neonatal jaundice; see unconjugated bilirubin
Wilson’s disease
Kayser – Fleischer rings
Alzheimer type II metabolic astrocytes
CADASIL –
Associated migraine HA
Anterior temporal damage
Family history - NOTCH 3 Gene, Chr 19
TPA & heparin must not be started simultaneously due to high risk of severe brain hemorrhage
DWI hyperintensity may persist for 2 months after stroke
Cytotoxic edema accounts for DWI not vasogenic edema
DWI can differentiate cytotoxic vs. vasogenic edema
lipoma
