Flashcards in Epilepsy Deck (21):
What sequence would you see cavernomas on?
T2*/ SWI for susceptibility and booming artefact
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%
Hippocampal hyperintenity without volume loss (3)
1. Status epilepticus
2. Low grade tumours: DNET and Astrocytoma
Ddx for black dots on T2*
2. Cerebral Amyloid Angiopathy- CAA
3. Hypertensive micro haemorrhage - DAI
What are the features of CAA
- In old demented patients
- normotensive with lobar haemorrhage
- peripheral location
Name the tumours associated with epilepsy: (4)
4. Hypothalamus hamartoma
What type of epilepsy does ganglioglioma cause?
Appearance of ganglioglioma?
cystic with enhancing mural nodule
Ca++ in 50%
What feature distinguishes ganglioglioma from PXA or DNET?
Appearance of DNET
Bubbly cystic mass
Appearance of PXA
supratentorial cyst with enhancing nodule
Meningeal enhancement- characteristic
If enhancement absent: PXA/ Ganglioglioma
Location of PXA
Characteristic of PXA
This is an enlarged hemisphere with ipsilateral ventriculonegaly.
Big volume = big ventricle
How would patients with hemimegacenphaly usually present with?
Small gyri- usually affects the Sylvian fissures
Atrophy- affects posteriorly
Anomalous venous return
This is arrested migration of neurons. There is nodular foci of grey matter intensity on all sequences.
Cleft in brain connecting the lateral ventricle to subarachnoid space
This is lined by grey matter.
Open vs closed lip
Schizencephaly vs porencephaly
Schizencephaly is lined by grey matter porencephaly is not
Key MRI features of Sturge Webber (3)
1. Leptomeningeal enhancement
2. Cortical tram track Ca++, low signal
3. Atrophy - post
High T2 signal - gliosis