CNS Flashcards
1
Q
maturation pattern in neonate
A
reach adult T1 in 1 yr
adult T2 in 2 yr
inf > sup
post > ant
cent > periphr
sens > motor
2
Q
what is the last part of the brain mylinate
A
subcortical WM.
occipt > 12 mo
front > 18 mo
FT finsih > 40 mo
PS: BS and post IC > mylinated at birth
3
Q
MC anomaly ass w/ ACC
A
IH lipoma
mcl: IH 2nd: Quadriq cistern
not tru neoplasm. cong
4
Q
Iniecephaly
A
extreme retrofelx of the head = star gazing fetus
large for mag
visceral anomaly
short neck
5
Q
Rhombencephalosynapsis
A
absence of the vermis and continuity of the cerebellar hemispheres, dentate nuclei, and superior cerebellar peduncles.
6
Q
DW varient vs DWM
A
vermis is hypoplastic in both
vs. DWM:
cerebellum is hypoplastic
no marked hydro
post. fossa is normal in size
7
Q
meckel gruber syndrome
A
occiptal enchepahlocele
polycystic kid
polydactyl
holoprosnch
8
Q
azygous ACA
A
lobar HPE
SOD
9
Q
SOD
A
ab. SP
ab. optic tract
schizencephaly
10
Q
Dyke-Davidoff-Masson syndrome
A
unlike Ramussen’s encph
there is calv expansion and sinuses pneumotization
11
Q
mildest form of lissencphaly
A
double cortex band hetrotopia
Xlinked, F>M
classic one is autosomal. M=F, CMV
12
Q
cobblestone lissencephaly
A
overmigration.
ass w/ congenital muscular dysplasia
retinal detach
13
Q
hydranencephaly causes
A
HSV is the mcc
2nd: toxo, CMV
14
Q
IH hypotension
A
Downward displacement of brain through incisura (brain "sagging") Diffuse dural thickening/enhancement Veins, dural sinuses distended Engorged pituitary gland Subdural hygromas/hematomas
15
Q
mcl of arachniod cyst
A
middle cranial fossa
16
Q
NB mets in kids
A
orbit
skull
dura
NOT BRAIN
17
Q
Pleomorphic Xanthoastrocytoma
A
cortical based, periphral, solid and cyst Temporal lobe mcl Supratentorial enhancing dural tail, no T2 edema peds = DIG
18
Q
Dysembryoplastic neuroepithelial tumor (DNET)
A
Benign mixed glial-neuronal neoplasm focal cortical dysplasia T lobe >> drug resistant seizure bubbly appearance > NO C+ peds < 20
19
Q
Oligodendroglioma
A
F lobe
1p/19q deletion > gd px
IDH1 > T2/flair mismatch
20
Q
medulloblastoma ass w/
A
Turcot syn: GBM
Gorlin syn: basal cell navus skin ca, odontogenic cyst
21
Q
mcc of IV mass in adult
A
central neurocytoma
|»_space; calcify, hetrogen, cystic and solid
22
Q
mcl of subependymoma
A
4th vent, foramen of monro
homogen C+
might not enhance
soft»_space; no hydro
23
Q
choriod plexus pap/ca
A
ca only in kids.
adult = 4th vent
24
Q
Meningoma in nuke
A
+ octerotide
+ Tc-MDP
25
mcl of dermiod cyst
1st: supracellar cistern
2nd: post. fossa
NF-2
26
Hemangiopericytoma
sarcoma
mimic aggressive mening
invade skull>> but no calc no hyperostosis
27
dysmoplastic infantile ganglioma
large cystic
supraten
< 1yr.
one lobe
28
NPH
> 0.3 evans index
| LP: drainage of 30-40 ml
29
porenchephalic cyst
WM lining the cyst
| mcc: 2/2 to periventricular hge infarct
30
perivent leukomalacia
wavy countors of lat ven
low vol of WM
ab SI
31
Joubert synd
ARD
molar teeth is high Sn but not Sp. for joubert
molar teeth means >> ataxia, develop delay and hypotonia
32
ACC is WNL
- up to 18 wk GA. you cant Dx ACC before that
| - agyric smooth app of the brain WNL until 26 GA
33
psuedotum cerebri LP pressure
> 25 mmHg
| TRV sinus stenosis is seen up 90%mc
34
mc ass w/ SOD
schizonepchaly
35
earliest manifestation of osmotic demylination
+DWI pons
| extrapontine loc might be seen: BG, EC, amygdala, cerebellum
36
Marchiafava-Bignami disease (MBD)
- is a rare CNS disorder
alcoholism and malnutrition.
- classically involves the corpus callosum with necrosis and demyelination. no ME.
- notice WE does not involve CC
37
methanol toxcity
optic nerve atrophy
hge putamen
WM necrosis
38
CO
GP hypoHU.
| T2 bright
39
mc CNS tumor post RTX
meningoma
40
mc brain changes post RTX
vascular mal
| cavernoma/teleangectasia
41
Chasing the dragon
Herion
| semiovale WM. PL of IC, deep cerebellum WM
42
mcl of MS in children
post. fossa.
| M = F
43
most Sn seq for spine and infratent MS
T2
44
subcortical arteriosclerosis encephalopathy
multi infarct dementia that involves the WM. spares U fibers
old
HTN
45
CADASIL
```
< 40 YO
mc heredidatry stroke
T lobe >>> classic
F and P lobes can be +
spares occipital L.
```
46
Hurler's diz
```
lysosomal
beaked L1 VB
metopic carcniosyn
prominant perivascular space
macrocephaly
```
47
MELAS
maternally inhertied
mitoch dis
elev lactate in spectro
involves P-O lobes
48
metachromatic leukodystrophy
AR lysosomal
| non SP WM + spares U fibers
49
X-linked leukodystrophy
P-O WM
50
canvan diz
```
AR, neonate, poor head control, hypotonia
High NAA
diffuse WM involve
GP
thalami
spares putamen
```
51
congenital HIV
BG Ca⁺⁺ in (not in adult)
Cerebral atrophy >> frontal
fusiform vasculopathy stroke
subarachnoid hemorrhage
52
congenital HSV encephalitis
hge encephalitis vs Rubella >> ischemia
53
cryptococcus
Dilated PVSs in deep gray nuclei of AIDS patient, no enhancement
54
Brain TB
basilar C+
hydrocephalus
vasculitis >> infarct
CN involve
55
Most Sn seq for HSV
DWI > T2
you might see bleeding in the adult type
56
west nile
T2 bright BG and thalamus
hge
pt from saudi
57
CJD = prion diz
Pulvinar sign: post thalamus
Hockey stick sign: dorsomedial tthalamus
rapidly progressive atrophy
gyriform DWI+
58
mcc of epi/subdural empyema
frontal sinusitis
59
cephalohematoma
subperiosteal hematoma
elevate the periostum. limited by stutures
no CL Sg.
mcl: P and O lobes
60
subgalaeal hematoma
not limited space.
| underneath galeal aponiorosis
61
sutural diastesis comp in adult
dural venous sinus thrombosis
| kids: leptomeningeal cyst
62
mc parasitic diz of the CNS
neurocystoscreosis
stage I vesicular: no edema or C+, cystic
stage II colliodal: edema C+
stage III grandular less edema and C+. start to calc
stage IV: nodular calcified: calc
63
non ketoic hyperglycemia
BG and BS CT hyperdensity
T1: high
no ME, no C+
looks similar to HE. look at Hx
64
WE
spares BG in adult
| common in children
65
opioid overdose, methanol tox
putamen hge necrosis SPARES GP
optic nerve atrophy
NO tox similar to B12 deficiency >> post col.
66
putamen hge necrosis seen in
methanol
cynaide
opiod
67
PRESS
involves both cortical and subcortical.
P and O lobes
DWI is -ve. but sever diz might be +ve
68
HE
acute: b/l symmetric insular and cingulate DWI+ve
Bilateral T1WI hyperintensity in basal ganglia (BG), particularly globus pallidus (GP)
69
hypo glu injury
GM > WM
CC and IC
hippocampus
BS, thalami and cerebllum >> spared
70
artery of percheron
paramedian thalami DWI+
71
Recurrent artery of Heubner infarct
Caudate and IC infarct
The recurrent artery of Huebner is a br off the ACA.
might get clipped during ACOM aneurysm Rx.
72
risk of IC aneurysm rupture
post circ > ant
| > 10mm 1% risk of rupture
73
risk of AVM rupture
small
small draining v
aneurysm
BG loc
74
mcc of IC vasculitis
PAN
75
mcc of CVD in the brain
SLE
76
sinonasal polyoposis pattern RF
CF
| ASA sensitivity
77
epistaxis
ant nasal septum
In max a
might be anastomosis between In max a and opthalmic a. pay attension to the eye
78
Parotid gland duct
| Stenson
arises from the anterior surface of the gland, traversing the masseter muscle. The duct then pierces the buccinator, moving medially.
It opens out into: the second upper molar.
79
Submandibular duct
| Wharton's duct
allows the passage of saliva from the submandibular gland to the sublingual papilla located anteriorly. ... It runs forward with lingual nerve and vein and hypoglossal nerve and opens into the sublingual papilla at the side of the frenulum of the tongue.
80
torus palatinus
bony exostosis off the hard palate. WNL
81
Dentigerous cyst = follicular cyst
Benign developmental jaw cyst associated with crown of unerupted tooth
3rd molar >> MCL
82
Keratocystic odontogenic tumor
B9 cystic neoplasm of jaw with aggressive behavior and high recurrence rate
no cortical destruction
mcc mand tumor
83
Ameblastoma = adamantinoma
```
expansile multiloculated mixed cystic & solid mandible mass, usually near 3rd molar
2nd mcc of mabible tumor
arise from dentigerous cyst 5-20%
painless
ADULT
```
84
odontoma
mcc mand tumor.
hamartoma
mature solid tum w/ lucent border
85
tornwoldt's cyst
Ovoid, cystic mass in midline nasopharyngeal mucosal space
| between longus coli ms
86
warhtin's tum on nuke is +ve on
FDG
Tc-Pert
Tc-MDP
87
mcc malg partiod tum
mucoepidermiod
2nd: ACC >> perineuoral spread ( melanoma too)
88
Rx of tonsillar ab
ABx
PTA: I&D
RP abscess >> Sx drainge
89
mcc of cong neck cyst
TGD cyst
90
mcc of 1ry mass in the prestyliod parapharngyeal space
salv gland BMT
| mcc lesion is extension from adjacent space
91
pott puffy tumor
OM
frontal sinusitis
epidural abscess
pic
92
nasal glial hetrotopia loc
no connecton w/ IC component
| dont C+ much
93
chonal atresia
bony comp is almost alwz
| pyriform aperture , 4 mm
94
Dx of CNS vasculitis
Sx BX
95
mc features of VA dissection
arterial stenosis
gold Dx: DSA
RX; AC if no hge infarct
ENV coil, or Sx embolization
96
rever cerebral vasocons synd: RCVS
female
SAH >> HA
vasospasm of small and med vessels
resolve both S&S and img within 3 mo
97
Mx of Cartiod cav fistual
direct: coil, stent or ballon or surgical ligation
indirect: conservative
98
moya moya is known as
pial vascular engorgement >> Ivy sign
Rx: conservatove, ASA in mild cases.
ECA and MCA anastimosis in sever cases
99
venous infarct SI
DWI might be -ve
100
most deadly comp of SAH
vasospasm
Dx: angiographic
fisher scale
Rx; NSAID, CCB, endovasc
101
MCC of septic CS thrombosis
S.aurus
fungal in immunocomp
Mx: ABx, AC, I&D if needed
SOV prominance seen in both CST and CCF
102
IC Amyloid affect which vessels
small and med size vs.
MRI is the SOC.
sporadic > hereditary
ADD
103
Rathke cleft cyst T2 SI?
T2 : hyperintense cyst with a hypointense, intracystic nodule
104
what are the types of hypothalnic hamartoma
parahypothalamic: precausious puberity
intrahypothalamic: galaztetic seizure
all F/U GM SI. no C+
105
Lymphocytic hypophysitis RF?
1- ipilimumab for metastatic melanoma. immuno Rx
2- Preg
3- post partum
so both men and women can get it
enlarged. Enhances intensely, uniformly
S&S depends on which seg is affected,
106
mcc of Jagular foramne mass
1st: paragan
2nd: shawanoma>> cystic, hge, no bone destruction
3: meningoma >> skull hyperostosis
mc nerve > 9
107
inverted pap
more in male
high rate of recurrence if not comp resected
rare transfor >> SCC
108
where do u measure nuchal thickness?
measured at cerebellum and thalamus
| >5 mm 97% Sp for Down
109
features of pulm nodules ass w/ malg
1- semi sold
2- irrg
3- slow doubling
4- lack of calc
110
mc cause of CJD
sporadic
| rarely zoontic
111
pointing toward the ventricle GM based mass
DNET >> no C+
| if there DDxL gamglioma, oligo
112
most reliable sign of ch DVT
prior US
113
chrionic pumb ass w/ ?
increased miscarriage X2
114
what is blake's pouch cyst
infravermian cyst that communicates with fourth ventricle
115
dehiscent jugular bulb
sigmoid plate between a high riding jugular bulb and the middle ear is absent, allowing the wall of the jugular bulb to bulge into the middle ear cavity.
116
esthino NB Px ?
good relative to othet H&N ca
arise from olf bulb
Mx: Sx and Rtx
117
how to differ b9 from path spine fracture ?
```
BM
STx
post element involve
hx of OP
but C+ is the least helpful features as both non healed fracture and ca will C+
```
118
eagle syndrome ? patak syndrome
elongated styliod > 3 cm
or cacl styliohyiod lig.
CN comp
119
DJD post spinal fusion most common loc ?
mcl >> lumber spine
above > lower level of fusion
least common T spine
10% of ppl get it
120
normal length of the styliod process ?
2.5 cm
| ]> 3 cm Eagle syndrome
121
Esinthenomueroblastoma time of onset ?
2nd and 6th decades
peritumor cysts
GD px !!!!
122
CADASIL MCL
ant temp lobe
123
MCL of spinal hemangioblastoma
thoracic. eccentric
124
MCL of giant perivascular space
1st: mesoncephalothalaic
2nd: WM
125
earliest finding of Osm demylination
DWI of the pons
126
MCL of inverted pap
lat wall of the nasal cavity, middle turbinate and max ostioum.
127
MCL of allergic fungal sinistis
ethmiod
128
CPA facial nerve shawanoma
super rare.
| MCL >> middle ear. dont call CPA mass CN VII shawanoma
129
NF1 mode of inheritance
50% genetic
| 50% acquired mutation
130
major reason of M&M w/ SAH
vasospasm
131
Enphesamtous OM organism ?
FusobCetrium
Clostridium
Enterobacteria GNR
132
MCL of spontaneous RP hge
Psoas ms
133
MCC of B9 cong orbital mass ?
Dermoid > extraoccular
134
MCC extraoccular orbital ca in kids?
rhabdo
RB >> INTRAOCCULAR
135
Tolso Hunt dis
IgG4 of the cavernous sinus
136
MCC of spontanous orbital hge
variz
137
MCC of orbital malg
mets
138
MCC of exopthalmus
graves
139
arachnioditis Mx?
```
intrathecal steriod
adhesion lysis
MCL: L/S
pseudomass on myeolgram
archnioditis ossificans
```
140
RA vs CPPD
RA: no calc. disc is normal. +ve lig laxity and ADI widening. invagination of the foramnen mag
CPPD: calc. psueodumass
141
Wt is the MCC of inherited polyneuropathy?
charcort Marrie tooth diz.
type 1: MC one, ADD
type II: 2nd mc, Xlinked
both motor and senor polyneurpathy
fusiform nerve enlargement NNO NO NO C+
Vs: NF1, lymphoma, amyliod or sarciodosis
142
Mx of chrodoma?
Sx + RTx
143
MCC of extradural mass?
mets
144
MCC of intradural extramed?
1st: shawanoma
2nd: menin: MCL: T>C>L
145
shawanoma:
NF2-
no malg degen
hge + cystic changes common
NEVER degen >> ca
146
neurofibroma
target >> non Sp.
might undergo malg degen
NF1
147
MTx of PNST?
Sx but reccurance is high w/ NF1/2
| presents w/ pain > weakness 2/2 DRG
148
MCL of OO in the spine
L/S
149
VHL Chr?
ADD
| Ch.3p
150
MCL of astrocytoma?
T > C
long segm 4-7 VB
eccentric
inflitrative
151
MCL of epend?
C>T
| central
152
Rx of aggressive spine hemang?
```
transarterial embol
RTx
veretroplasty
ethanol inj
Sx
```
153
MCC of Spine diz in HIV pt?
HIV myelitis
T > C.
ATROPHY
POST col.
154
MCC of CN ab ass/ GBS?
CN VII
155
MCL loc of spine hemangioblastoma
T > C
156
Type I caudal regression?
Sacral agensis > S1
| cord terminates at T11-T12, blunted
157
type II caudal reg?
cocyx agenisis
| conus terminates at L3-L4
158
Cong ab ass/ w/ caudal regression
MC GU: renal agensii and hydro
MC GI: anal atresia, imper anus
VB seg anomaly
159
Wt is block VB?
fusion w/ disc
160
Normal C+ of CNVII?
labyrnith, tympnaic, Ganiculate, mastiod
AB: cancicular, cictsernal and extratemporal
161
Weekly QC mr ?
```
Center fr
Table position
Setup and scanning
Geometric accuracy
High And low contrast resolution >> phantom
Artifact analysis
Film quality control
Visual check list
```
162
Annual QC mr
B0 homogeneous
Slice thickened accuracy and position
RF coil
Display monitor
