WlwG Head (excl neuro) Flashcards
Eye globe: Dense T2-hypo intra-ocular mass with calcifications behind pupil in child
Retinoblastoma
Eye globe: T1-hyper posterior exophytic mass
Melanoma
Eye globe: CT-hyper vitreous with small globe
Persistent Hyperplastic Primary Vitreous (PHPV)
Eye globe: T1-hyper densities without calcifications in one eye in child
Coats disease (haemorrhage)
Eye: Posterior outpouching of globe
Coloboma
Eye: AP elongation of globe
Myopia
Eye: Large globe with raised intra-ocular pressure in child
Buphthalmos
Eye globe: Detachment at medial and lateral sides of globe, sparring posterior globe
Choroid detachment
Eye globe: V-shape detachment with involvement of posterior as well as medial/lateral globe
Retinal detachment
Eye: Optic nerve head calcifications
Drusen
Eye: Optic nerve and canal enlargement in child
Optic nerve glioma
Eye: Circumferential enhancement around optic nerve with linear bands of enhancement in adult
Optic nerve meningioma
Eye: Unilateral painful nerve enhancement without enlargement
Optic neuritis (from MS/ADEM)
Eye: Unilateral extra-ocular well-defined T2-hyper lesion in adult, extra-conal
Orbital cavernous venous malformation
Eye: Unilateral extra-ocular T2-hyper cystic mass with haemorrhage in child, extra-conal
Orbital lymphangioma/lymphatic malformation
Eye: Extra-ocular medial socket mass in child
RhabdoMyoSarcoma (“Lymphoma lateral, rhabdoMyosarcoma medial”)
Eye: Extra-ocular lateral socket fatty mass in child
Dermoid
Eye: Extra-ocular lateral socket enhancing/diffusion restricted mass
Lymphoma (“Lymphoma lateral, rhabdoMyosarcoma medial”)
Eye: Periorbital and surrounding optic nerve mass with proptosis, extra-conal
Neuroblastoma mets
Eye: Extra-conal lesions (x4)
(“Unilateral = Malformations/Mets, Bilateral = Thyroid eye”):
Orbital cavernous venous malformation: Well-defined T2-hyper benign vascular malformation in ADULT.
Orbital venous lymphatic malformation aka lymphangioma: Extra-conal cystic mass with haemorrhage in CHILD, T2-hyper.
Neuroblastoma mets: Periorbital/surrounding optic nerve mass causing PROPTOSIS and ‘Raccoon eye’ appearance.
Eye: Conal (aka muscular layer) lesions (x4):
RhabdoMyoSarcoma: Large SUPERIO-MEDIAL SOCKET malignant soft tissue mass in CHILD
(“RMS = Really malignant in medial socket”).
Dermoid: SUPERIO-LATERAL SOCKET benign FATTY mass in child.
Orbital lymphoma: Superio-lateral socket with homogeneous ENHANCEMENT and DR.
Orbital Pseudo-tumour: PAINFUL, unilateral extra-orbital muscle/LATERAL RECTUS thickening/inflm
- If involves cavernous sinus = Tolosa Hunt syndrome.
Eye: Unilateral orbital muscle/lateral rectus thickening and inflamation, T2-hypo, not involving cavernous sinus
Orbital pseudo-tumour***
(“Thickening, thus not real tumour”)
Eye: Unilateral orbital muscle/lateral rectus thickening and inflamation, T2-hypo, also involving cavernous sinus
Tolosa Hunt syndrome***
Eye location vision and cause: Optic nerve
Monocular vision, from MS/GCA
Eye location vision and cause: Optic chiasm
Bitemporal hemianopia, frmo TB/Sarcoid/aneurysm
Eye location vision and cause: Optic tract
Homonymous hemianopia, intracranial causes thus infarct/bleed
Eye location vision and cause: Parietal optic radiation
Inferior homonymous quadrantopis, intracranial causes
Eye location vision and cause: Temporal optic radiation
Superior homonymous quadrantopia, intracranial causes
Eye location vision and cause: Occipital lobe
Homonymous hemianopia with macular sparing, intracranial causes
Eye location vision: CN3
Down and out eye with ptosis and pupil dilation
Eye location vision: CN4
Cannot down and in (superior oblique, SOLAR)
Eye location vision: CN6
Cannot out (lateral rectus)
Eye: Bilateral symmetrical painless proptosis
Thyroid eye disease
Eye: Thyroid eye disease muscles involved
IMST = Inferior -> medial -> superior -> lateral
Ear Pulsatile Tinnitus: Increased bony formation around middle ear
Otosclerosis
Ear Pulsatile Tinnitus: Mass-like vessel with enlarged facial nerve canal
Persistent stapedial artery
Ear Pulsatile Tinnitus: Enhancing ++ mass at jugular bulb +/- bony erosion
Glomus tumour, dense blush on angiography
Ear Pulsatile Tinnitus: Enlarged inferior tympanic caniliculus
Aberrant ICA
Ear Pulsatile Tinnitus: Enlarged middle ear endolymphatic space with ear fullness
Menieres
Ear Pulsatile Tinnitus: ICA issues
ICA dissection/aneurysm/stenosis
Ear conditions: EAC expansion without bony erosion
Keratosis obturans
Ear conditions: EAC/middle ear erosion, T1-hypo, T2-hyper, diffusion restriction
Cholesteatoma
Ear conditions: EAC/middle ear erosion, T1-hyper
Cholesterol granuloma
Ear conditions: EAC/middle ear erosion, mastoiditis, DM
Malignant OE
Ear conditions: Middle ear fluid
Otitis media
Ear conditions: Middle ear (cochlear/semicircular canal) enhancement
Labyrinthitis
Ear conditions: Middle ear ossification
Labyrinthitis ossificans
Ear conditions: Fluctuating hearing loss and vertigo following cholesteatoma
Labyrinthine fistula
Ear conditions: Vertigo/nystagmus with semicircular canal defect
Superior SCC dehiscence
Ear conditions: Petrous apex inflm with CN5/7 pain
Petrous apicitis
Ear conditions: Petrous apex inflm with CN6 pain/palsy (+/- CN5/7)
Gradenigo (“Graduate at the apex vs To lose a hunt in the Cave - Tolosa hunt involves cavernous sinus”)
Ear conditions: Petrous temporal bone fracture, which nerves involved
CN7/8 affected wtih post-auricular haematoma/battle sign
Ear conditions: CN7 palsy from herpes simplex infn
Bell’s palsy
Ear conditions: Which part of CN7 affected by Bell’s palsy
Labyrynthine CN7
Eye conditions: Cavernous sinus inflm, CN3/4/6 palsy and facial pain
Tolosa hunt
Eye conditions: Cavernous sinus swelling, CN3 palsy
Cavernous sinus thrombosis
Skull base/Nose: Olfactory groove/sphenoidal plane mass
Meningioma
Skull base/Nose: Heterogeneous enhancing mass at upper nose with bone erosion
Olfactory neuro-blastoma
Skull base/Nose: T1/T2-hypo bone lesion with enhancement and expansion
FibroDysplasia
Sinus: Involves ostium
Antrochoanal polyp
Skull base/Nose: Congenital obstruction in posterio-nose with breathing obstruction
Choanal atresia
Skull base/Nose: T2-hyper mass in maxillary sinus/nasal cavity
Sinonasal SCC
Skull base/Nose: Lateral nasal wall polypoid enhancing lesion with bony erosion
Inverted papilloma ***
Skull base/Nose: Sphenopalatine/pterygopalatine vascular mass with epistaxis in child
Juvenile angiofibroma
Sinus: Mucosal thickening
Sinusitis
Sinus: Small rounded lesion
Mucous retention cyst
Sinus: Occupies entire sinus, non-enhancing
Mucocoele
Sinus: Lesion with bone erosion
Inverted papilloma
Sinus: Heterogeneous lesion, centrally dense with peripheral enhancement
Mycetoma
Sinus: Diffuse sinusitis with polyps, T2-hypo
Allergic fungal sinusitis
Sinus: Sinus opacification with bony erosion in DM/steroid/immunocompromised
Invasive fungal sinusitis
Sinus: Enhancing T2-hyper aggressive and invasive lesion
Sinonasal SCC
Mouth/Pharynx: Aggressive enhancing mass with bone erosion
Oropharyngeal squamous cell ca / OPSCC, associated with HPV/smoking
Mouth/Pharynx: Thin-walled cyst at floor of mouth/submental region
Dermoid/epidermoid cyst
Mouth/Pharynx: Inflamation from dental infn
Phlegmon
Mouth/Pharynx: Floor of mouth rapidly worsening infn
Ludwig angina
Mandible/Maxilla: Round cyst in bone with dental infn
Odontogenic cyst
Mandible/Maxilla: Round cyst in bone with unerupted tooth
Dentigerous follicular cyst
Mandible/Maxilla: Soap bubble multilocular lucency in bone
Ameloblastoma (cementoma is opacity)
Mandible/Maxilla: Opacity with lucent surrounding halo at tooth root
Cementoma (ameloblastoma is lucency)
Mandible/Maxilla: Malformed tooth
Odontoma
Mandible/Maxilla: Multiple basal cell carcinoma and karatocysts
Gorlin-Goltz
Mandible/Maxilla: Pain, clickling, locked jaw
TMJ dysfunction
Mandible/Maxilla: Jaw hypertrophy with multiple cysts
Cherubism
Mandible/Maxilla: Multilocular painless bone lucency with scalloped margins
Giant cell granuloma
Mandible/Maxilla: Invasive lesion in child
Rhabdosarcoma
Mandible/Maxilla: Invasive lesion in adult
Chondrosarcoma
Mandible/Maxilla: Le Fort fractures 1-3?
1 = horizontal across maxilla, 2 = pyramidal, 3 = craniofacial.
Nasopharynx/Retropharynx: Symmetric midline masses, no bony erosion, no LN
Adenoid hyperplasia (tornwaldt is single, Waldeyers has LN)
Nasopharynx/Retropharynx: Single midline cyst, T1-var, T2-hypo
Tornwaldt cyst (adenoids are bilateral)
Nasopharynx/Retropharynx: Symmetrical bilateral mass with LN
Waldeyers lymphoma (Adenoid hypertrophy no LN)
Nasopharynx/Retropharynx: Widened prevertebral space with enhancement
Retropharyngeal abscess
What is Tullio phenomenon?
Tullio phenomenon = Vertigo/nystagmus from Superior SCC dehiscence