Brain and spine imaging Flashcards
Confluent white matter lesions in a child
ADEM MS Dysmyelination: Alexander, Canaavan, MCLD, XLACD Treatment related leukodystrophy MELAS
Ring enhancing lesion
Metastasis Abscess GBM Infarct Contusion Demyelination Radiation necrosis
Pineal Mass
Pineoblastoma: young, enhance, restrict, drop mets, peripheral calc
Pineocytoma/pineal cyst: peripheral calc, pineocytoma enhances
Germinoma/teratoma/YST/choriocarcinoma: young, central calc, gan restrict and enhance, fat if teratoma, drop met
adjacenet meningioma or tectal plate glioma
Sellar/suprasellar mass in child
RCC - don’t enhance, can have nodule, often t1 bright, claw of enhancing pituitary, 25% calc - no calc helps differentiate
Craniopharyngioma - adamantinomatous cystic/solid with calc in 90%, t1 bright “crank oil”, papillary solid no calc
Granulomatous hypophysitis
Germ cell tumour
Hypothalamic hamartoma (enhances=glioma)
Optic nerve glioma
PF mass in child
Medulloblastoma: most common, hyperdense, restrict, roof, 20% calc, drop mets/zuckerguss
Ependymoma: toothpaste, calcify, floor, 50% calc.
JPA: cyst and nodule, 20% calc, 2nd commonest
ATRT
Brainstem glioma
PF mass in adult
Metastasis
Haemangioblastoma
Lhermitte-Duclos/AVM/cavernous malformation
Infarct/bleed
Confluent white matter lesions in adult
Demyelination
Toxic/metabolic leukoencephalopathy: chemotherapy/radiotherapy
Vasculopathy
Neoplasm: gliomatosis cerebri pattern, lymphoma
Atypical infection: HIV leukoencephalopathy/Progressive multifocal leukoencephalopathy
CADASIL: 30-50, spares subcortical U, anterior temporal lobes and external capsule initially involved, thickened vessel BM
MELAS: childhood/early adult, predilection for parieto-occipital
PF malformation
DW malformation: torcula/lambdoid inversion
DW variant/vermian hypoplasia: abnormal fastigial point, no torcula/lambdoid inversion
Blakes pouch cyst: increased cerebellovermian angle, normal fastigial point
Mega cisterna magna
Arachnoid cyst
Joubert syndrome
CPA mass
VS Meningioma Epidermoid Arachnoid cyst Aneurysm
Cerebellar tonsillar herniation
raised intracranial pressure: mass, oedema, IIH
intracranial hypotension
chiari 1/2/3 malformation
CSF lined cortical cleft
schizencephaly is GM lined: open lip (T2) closed lip (T1) associated with septo-optic dysplasia
Porencephalic cyst:lined by gliotic WM
Encephalomalacia:lined with gliotic WM but doesnt communicate with ventricle
Enhancing intramedullary spinal lesion
haemangioblastoma astrocystoma ependymoma demyelination metastasis
Intradural extramedullary mass
nerve sheath tumour
meningioma-dont have to have a dural tail
epidermoid
metastasis
Diffuse infiltrating temporal lobe mass/oedema
HSV encephalitis: patchy enhancement, restriction, haemorrhage, spares BG
Limbic encephalitis:brain/lung, subacute onset, non-haemorrhagic
Low grade glioma/gliomatosis cerebri
Status epilepticus
Infarct- venous with vein of labbe
Cortically based cystic temporal lobe mass in a patient with seizures
Ganglioglioma: cortical cyst with nodule, 50% enhance and calcify, scallops calvarium
Pleiomorphic xanthoastrocytoma: cortical cyst with nodule, enhancing dural tail
Dysembryonic neuroepithelial tumour: associated with cortical dysplasia. Calcification and enhancement are uncommon.
Intraparenchymal haemorrhage
Contusion
Primary intracerebral haemorrhage - hypertensive vs. amyloid angiopathy
Haemorrhagic lesion: metastasis(MRCT)/GBM or vascular
Corpus callosal lesion
Toxic demyelination: Machiafavi bignami/antiepileptics/Chemotherapy
Oedema post seizure
GBM
Lymphoma
Radiation necrosis
Demyelination
Diffuse axonal injury (GW->CC->Brainstem)
Subependymal nodules
SEN or SEGA in TS
Grey matter heterotopia
Torch infection (CMV>toxo)
Metastases
Massive supratentorial CSF collection in a newborn
Massive hydrocephalus Hydraencephaly Alobar holoprosencephaly Agenesis of the corpus callosum with midline interhemispheric cyst Bilateral open lip schizencephaly
Intraventricular mass
Choroid plexus papilloma Central neurocytoma Metastasis Meningioma Ependymoma SEGA
Cerebellar atrophy
Alchohol abuse
Antiepileptic therapy
Paraneoplastic syndrome
Multisystem atrophy
Spinal cord signal abnormality
intramedullary neoplasm: ependymoma (adults, heterogeneous, circumscribed)/ haemangioblastoma/metastasis/astrocytoma (children, diffuse, homogeneous) demyelination transverse myelitis cord infarct (grey matter) Spinal AVM B12 deficiency/HIV myelopathy contusion
solitary region of cortical and subcortical signal abnormality in an adult
Infarct Glioma Cerebritis Contusion Seizure oedema
Epidural spinal mass
Disc extrusion Epidural haematoma - GRE Epidural abscess Metastasis Lipomatosis -steroids/obesity Synovial cyst
