RITE Images 2006 Flashcards
Angiosarcoma – obstructing straight sinus à increased ICP
RPLS
Alcoholic cerebellar degeneration – atrophic cerebellar vermis & loss of Purkinje & Granule cell neurons
Cavernous angioma – T2 images – dark rim b/c of hemosiderin deposition from repeated bleeding
No flow in basilar artery
L hyperdense MCA sign – occlusion of vessel; early sign of acute stroke
Putaminal hemorrhage 2ndary to HTN
Pt complains of back pain
Tethered cord syndrome;
see
-thickened filum terminale,
-widening of spinal canal
-Posterior cord lipoma
-Low lying spinal cord
CNS fistula communicating the SAS w/ the pleural cavity
Pick section C?
Cholesteatoma – an epidermoid tumor
T1 shows the tumor entering the internal auditory canal & altering normal structure of petrous bone
- Does NOT enhance w/ GAD; what enhances w/ GAD? Meningioma schwanomma, chordoma*
- Acoustic neurinomas are usually infratentorial*
- Astrocytoma DOES NOT enhance w/ GAD*
Neurofibromatosis
Subcortical hemorrhage – the most common cause of this is trauma in young person
Persistent trigeminal artery supplying the L posterior circulation; no L PCA b/c of this
Embolic infarction – cortical & subcortical lesions; L SMG
MS
What clinical feature would you expect to see in a patient with this abnormality?
Lesion to caudate ->chorea
LMCA ischemic lesion/infarct 2ndary to occlusion;
Neurofibromatosis - has focal areas of signal intensity (FASI)
Tolosa Hunt Syndrome – painful opthalmoplegia, abnormalities in cavernous sinus
Lobar atrophy or Pick’s disease
What syndrome would this patient have?
Locked in syndrome – poor prognosis for recovery sufficient to be weaned from mechanical ventilation
14-6 positive spikes – sharply contoured in posterior head during light sleep
Best seen on referential montage & most common in adolescent patients
GBM
Removal of SDH
PLEDS in L temporal area – think about HSV encephalitis -> acyclovir
Hippocampal atrophy
Occlusion to atheroclerosis @ proximal ICA
Anterior temporal spikes on EEG + fever + focal seizures -> cerebral abscesses
Hereditary neuropathy w/ liability to pressure palsies – sausage-like change in myelin in teased nerve preparation -> tomaculous neuropathy;
Deletion of PMP22 gene
No MCA
Cerebral atrophy is most closely associated w/ PROGRESSION of disability in MS
GAD enhancing plaques – most important factor for dx MS
Focal polymorphic delta activity – suggestive of underlying structural lesion
Arachnoid cyst – respects the cortex
LGN
Patient has repeated aphasic episodes
Perisylvian AVM -> causes the pt’s repeated aphasic episodes
Symmetrical dilatation of ventricular system & sylvian fissure w/o excessive sulcal widening or hippocampal atrophy
Cyst contiguous w/ 4th ventricle from surgial excision of cerebellar astrocytoma
PICA infarct – inferomedial portion of cerebellar hemisphere
Benign rolandic epilepsy -> observe w/o AED
Lipoma – (small lesion in infundibular region); T1 image w/ fat suppression
Hypoparathyroidism – symmetrical high density lesions are calcifications in the media of the small vessels in lenticular nuclei, thalami & centrum semiovale of frontal lobe
Chiari type I – cerebellar tonsils are descended below the foramen magnum
Substantia nigra – fxns to facilitate voluntary motor activity originating in the prefrontal 7 motor cortex ipsilateral to SN => damage to one SN -> hemiparkinsonism
Hemiparkinsonism is contralateral to the lesion
Open ring sign -> demyelinating lesions
Ring enhancing lesion osteomyelitis
Obstructive (noncommunicating) hydrocephalus – marked enlargement of lateral & 3rd ventricles; can be seen in aqueductal stenosis
Hydatid cysts of the spinal canal w/ involvement of the vertebral bodies in the region of the lesion
Epidermoid – tumor in prepontine cistern compressing root of trigeminal nerve -> pain,
does NOT enhance w/ GAD, “whorled appearance on FLAIR”
Ependymoma – tumor arises from spinal canal & molds the vertebral bodies; intramedullary
NOT chordoma -> would come from vertebral bodies esp sacrum & compress SC
Cysticercosis – multiple cystic lesions w/ high intensity/density dot = scolex of tenia solium;
intraventricular cysts block the CSF pathways -> hydrocephalus
Patient complaining of neck stiffness
Astrocytoma – intramedullary; pt complaining of neck stiffness b/c tumor eroding vertebral bodies
Subacute hemorrhage – pick hemorrhagic infarct (b/c of small size) [embolic occlusion of branch of ACA] > AVM
Panthothenate kinase associated neurodegeneration (PKAN) – progressive neurodegenerative disease w/ neuroaxonal dystrophy, rust brown discoloration of globus pallidus pars reticulata of substantia nigra
Accumulation of iron; onset <15
PANK2 gene
Normal scan of 4 month old child – Gray/white matter signal reversed during 1st year of life
Dolichoectasic vessels pushes brainstem away from IAC
Tuberous sclerosis –
subependymal nodules
white matter lesions following lines of neuronal migration, cyst like white matter lesions
Autosomal dominant SCA type 6 – pure cerebellar atrophy esp superior vermis
Conduction block on NCS diagnoses CIDP
Warfarin is RELATIVELY contraindicated in pts w/ prior lobar ICH
Lambert Eaton syndrome
Weakness in LES responds to 3’-4’ diamonopyridine – blocker of K channel on presynaptic membrane
Syringomyelia w/ cerebellar tonsil herniation -> chiari type I
Syringomyelia b/c of T2 hyperintensity in cord on T2
Tumor in pituitary fossa
Hypoperfusion of parietal lobe -> AD
Infarction; Pt w/ Horner’s ipsilateral to MCA or ACA territory infarction -> need to think about carotid dissection
If affect the PCA territory -> think about carotid dissection due to the possibility of a persistent trigeminal artery
Enlargement of temporal horns of lateral ventricles suggesting hippocampal atrophy - AD
Cavum vergae – developmental cavity of the roof of the 3rd ventricle
Pt treated w/ VP shunt for obstructive hydrocephalus
Trauma – high signal changes in L temporal & frontal regions
Inferior frontal gyrus in A & superior temporal gyrus in B – lesions of the crowns of gyri
C3 myelopathy – cord signal hyperintensity; sensory level
Upper cervical myelopathy - possibly caused by compression of ASA by osteophytes
Multiple sclerosis – periventricular plaque
Extrapontine myelinolysis – lesions @ cortical G/W matter junctions
Leukoaraiosis – ill defined white matter loss due to chronic vascular disease &
