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Neuroradiology > Epilepsy > Flashcards

Flashcards in Epilepsy Deck (21):
1

What sequence would you see cavernomas on?

T2*/ SWI for susceptibility and booming artefact

2

How would cavernomas look like on MRI?

1. Popcorn ball with haemosiderin rim
2. T2*/ SWI for susceptibility / bloom artefact- Punctate low foci- black dots on T2*
4. DVA: Developmental venous anomaly
4. CT -v in 50%
Ca++ 50%

3

Hippocampal hyperintenity without volume loss (3)

1. Status epilepticus
2. Low grade tumours: DNET and Astrocytoma
3. Encephalitis

4

Ddx for black dots on T2*

1. Cavernomas
2. Cerebral Amyloid Angiopathy- CAA
3. Hypertensive micro haemorrhage - DAI

5

What are the features of CAA

- In old demented patients
- normotensive with lobar haemorrhage
- peripheral location

6

Name the tumours associated with epilepsy: (4)

1. Ganglioglioma
2. PXA
3. DNET
4. Hypothalamus hamartoma

7

What type of epilepsy does ganglioglioma cause?

TL epilepsy

8

Appearance of ganglioglioma?

cystic with enhancing mural nodule
Ca++ in 50%

9

What feature distinguishes ganglioglioma from PXA or DNET?

Ca++

10

Appearance of DNET

Bubbly cystic mass
Wedge shaped
swollen gyri
FCD
+/- enhancement

11

Appearance of PXA

supratentorial cyst with enhancing nodule
Meningeal enhancement- characteristic
If enhancement absent: PXA/ Ganglioglioma

12

Location of PXA

Spratentorial

13

Characteristic of PXA

Peritumeral oedema
Meningeal enhancement

14

Define hemimegalencephaly:

This is an enlarged hemisphere with ipsilateral ventriculonegaly.

Big volume = big ventricle

15

How would patients with hemimegacenphaly usually present with?

Developmental delay
Seizures
Contralateral hemiparesis

16

Define polymicrogyria;

Small gyri- usually affects the Sylvian fissures

Atrophy- affects posteriorly
Anomalous venous return

17

Define heterotopia

This is arrested migration of neurons. There is nodular foci of grey matter intensity on all sequences.

No enhancement

Types:
- subependymal
- subcortical

18

Define schizencephaly

Cleft in brain connecting the lateral ventricle to subarachnoid space

This is lined by grey matter.

Open vs closed lip

19

Schizencephaly vs porencephaly

Schizencephaly is lined by grey matter porencephaly is not

20

Key MRI features of Sturge Webber (3)

1. Leptomeningeal enhancement
2. Cortical tram track Ca++, low signal
3. Atrophy - post

High T2 signal - gliosis

21

What eye problem is seen in patients with sturge webber syndrome?

Vascular malformation of choroid of eye - enlarged eye secondary to increased pressure. Hemianopia

Choroid haemangioma

Also be aware of the port wine strain on face