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DDx > Brain > Flashcards

Brain Flashcards

0
Q

Causes of low T2 basal ganglia

A 
Childhood hypoxia
Haemosiderin
Old age
MS
PD
Calcium
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1
Q

Causes of bright T1 basal ganglia

A 
Haemorrhage
Haemorrhagic infarction
Wilson's
Long term PTN
Calcification
Hamartomas (NF1)
Chronic hepatic encephalopathy
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2
Q

Causes of bright T2 basal ganglia

A

Lymphoma
Ischaemia (hypoxic encephalopathy, venous thrombosis)
Neurodegenerative diseases (eg Huntington’s, Wilson’s, CJD, Leigh disease)
Toxins (eg CO, cyanide, hypoglycemia, methanol)

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3
Q

McDonald’s criteria

A

Dissemination in space: 1 T2 lesion or more in at least 2 MS typical CNS regions (peri ventricular, juxtacortical, infratentorial, spinal cord)

Dissemination in time: simultaneous asymptomatic contrast enhancing and non enhancing lesions at any time OR a new T2/contrast enhancing lesion on follow up imaging OR a second clinical attack

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4
Q

Increased T2 signal in BG/thalami in child

A 
Ischaemia (hypoxic ischaemic encephalopathy)
CO poisoning
Wilson disease
Mitochondrial disorder (Leigh, MELAS)
Kernicterus
Osmotic demyelination
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5
Q

Cerebellar atrophy

A 
Alcohol
Anticonvulsant therapy
Paraneoplastic syndrome
Sporadic olivopontocerebellar atrophy
Cerebello-olivary degeneration
Friedrich ataxia
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6
Q

Intraparenchymal haemorrhage

A 
Hypertension (most common)
Tumour
Trauma
AVM
Aneurysm
Coagulopathy
Amyloid angiopathy
Emboli
Hemorrhagic infarction (especially venous)
Vasculitis
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7
Q

Corpus callosal lesion

A 
Lymphoma
GBM
Demyelinating disease
DAI
Marchiafava Bignami disease
PML
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8
Q

Cortically based enhancing neoplasm

A 
Oligodendroglioma
Astrocytoma
Ganglioglioma
DNET
Desmoplastic infantile glioma
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9
Q

Extra-axial mass, hemispheric

A 
Meningioma
Metastases
Lymphoma
Arachnoid cyst
Dermoid/epidermoid
Other: hemorrhagic, infectious fluid collections
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10
Q

Extra-axial mass, clivus

A

Metastases
Meningioma
Chordoma
Chondroma, chondrosarcoma

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11
Q

CP angle mass

A 
CN VIII neuroma (also CN V, CN VII)
Meningioma
Epidermoid
Paraganglioma
Petrous apex cholesterol cysts
Aneurysm
Metastases
Other (arachnoid cyst, lipoma, dermoid less common)
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12
Q

Intra-axial mass, cerebellum

A 
Astrocytoma
Medulloblastoma
Hemangioblastoma
Metastases
Ependymoma/choroid plexus papilloma or carcinoma
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13
Q

Multiple intra-axial lesions

A 
Tumor
• Metastases
• Multicentric glioma
• Lymphoma
Infection
• Abscess
• Fungus
• Cysticercosis
• Toxoplasmosis
Vascular
• Embolic infarctions
• Multifocal hemorrhage
• Diffuse axonal injury
• Contusions
• Cavernous hemangiomas
• Vasculitis
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14
Q

Suprasellar mass

A 
Sellar lesion with superior extension, sarcoidosis
Aneurysm, arachnoid cyst
Teratoid lesions: Germ cell tumours, epidermoid/dermoid
Craniopharyngioma
Hypothalamic glioma
Metastases, meningioma
Optic nerve glioma
EG
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15
Q

Thickened pituitary stalk

A 
Adenoma
Lymphoma
Sarcoid
Infection (TB)
EG (causes diabetes insipidus, kids)
Lymphocytic hypophysitis (if pregnant)
16
Q

Cerebellar mass, child

A

Cerebellar astrocytoma
Medulloblastoma
Brainstem glioma
Ependymoma

17
Q

Cerebellar mass, adult

A

Metastasis
Haemangioblastoma
Astrocytoma
Extraaxial tumors (meningioma, schwannoma, epidermoid)

18
Q

Brain tumour, infant

A

Teratoma (most common)
PNET (primary cerebral neuroblastoma)
Choroid plexus papilloma/carcinoma
Anaplastic astrocytoma

19
Q

Lateral ventricle tumour

A

0-15 years: PNET, choroid plexus papilloma
15-30: glioma, juvenile pilocytic astrocytoma
>30: subependymoma, astrocytoma, metastases, oligodendroglioma, meningioma, central neurocytoma

20
Q

3rd ventricle tumour

A

0-15 years: astrocytoma, EG of stalk, germinoma, extrinsic craniopharyngioma
15-30: colloid cyst
>30: glioma, metastases, pituitary or pineal masses, other (eg, aneurysm, sarcoid)

21
Q

4th ventricle tumour

A

0-15 years: ependymoma, medulloblastoma
15-30: choroid plexus papilloma
>30: metastases, haemangioblastoma, subependymoma

22
Q

Pineal region mass

A 
Pineocytoma, pineoblastoma
Germ cell tumour
Meningioma
Glioma
Metastasis
Lymphoma
Pineal cyst
Vein of Galen malformation
23
Q

Cystic neoplastic mass

A 
Cystic astrocytoma/GBM
Ganglioglioma
Pleomorphic xanthoastrocytoma
DNET
Hemangioblastoma
Metastases: squamous cell carcinoma
24
Q

Haemorrhagic metastases

A

Choriocarcinoma, thyroid, melanoma, RCC

25
Q

Diffuse meningeal enhancement

A

Meningitis (viral, bacterial)
Carcinomatosis (Lymphoma, metastases - melanoma, breast, lung)
Postoperative/postshunt (SAH, intracranial hypotension)
CSF leak

26
Q

Basilar meningeal enhancement

A 
Infection
• TB (most common)
• Fungal
• Pyogenic (more common on convexity
• Cysticercosis
Tumor
• Lymphoma, leukemia • Carcinomatosis
Inflammatory
• Sarcoid
• Rheumatoid pachymeningitis (also SLE and Wegener granulomatosis)
• Whipple disease
27
Q

Ependymal enhancement

A

Tumour (lymphoma, metastases - lung, melanoma, breast)
Infection (meningitis, CMV)
Inflammatory ventriculitis (post shunt, post haemorrhage)

28
Q

Basal ganglia calcification

A

Senescent/physiologic/idiopathic calcification (most common)

Metabolic calcification
• Hypoparathyroidism (most common meta- bolic cause)
• Pseudohypoparathyroidism
• Pseudo-pseudohypoparathyroidism
• Hyperparathyroidism

Infection
• TORCH, AIDS • Postinflammatory: TB, toxoplasmosis • Cysticercosis (common)

Toxic/postanoxic
• Lead • CO • Radiation therapy • Chemotherapy

Other
• Fahr disease
• Mitochondrial (common), encephalopathies

29
Q

Causes of dural metastases

A

Breast, lymphoma, prostate, and neuroblastoma

DDx (5 decks)

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