Head/ Brain injury imaging

Question 1

Imaging for stroke ?

Answer 1

CT

Question 2

imaging for malformation and inborn disease ?

Answer 2

MRI

if CI, then use CT

Question 3

Imaging for Brain trauma?

Answer 3

CT

MRI as 2nd line

Question 4

Imaging for cerebrovascular disease?

Answer 4

CT+angio/MRI+angio

Angiography for the intervention part

Question 5

In brain trauma what imaging is particulary important for hemmorhage?

Answer 5

MRI

Question 6

Imaging for neurodegenerative diseases?

Answer 6

MRI

and/or PET/SPECT

Question 7

Imaging for infectious/inflammatory disease in the brain?

Answer 7

MRI

Question 8

Imaging for tumors in the brain?

Answer 8

MRI+contrast and/or functional imaging

Question 9

what is the main technique for morphological and functional imaging of the brain?

Answer 9

MRI

Question 10

How does malignant brain tumors appear on MRI?

Answer 10

Intense, non-homogenous impregnation

Question 11

What is an Arteriography?

Answer 11

An imaging test that uses x-rays and a special dye to see inside the arteries.

Question 12

what is Digital subtraction angiography?

Answer 12

A fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment.

Question 13

What is a fluoroscope?

Answer 13

an instrument with a fluorescent screen used for viewing X-ray images without taking and developing X-ray photographs.

Question 14

What is the indication of Digital subtraction angiography?

Answer 14

treat brain aneurysm, arterio-venous malformation and occlusion/stenosis.

Question 15

what is the use of US in head imaging?

Answer 15

Very useful for newborn brain

Question 16

Hypodense lesion on brain CT indicates?

Answer 16

Ischemia

Question 17

Hyperdense lesion on brain CT indicates?

Answer 17

Hemorrhage

Question 18

What is the advantage of CTA over DSA?

*Digital subtraction angiography

Answer 18

CTA carries less of a risk for developing neurological complications compared with DSA because of the minimally invasive nature of the procedure.

Question 19

What contrast do we use in brain CT?

Answer 19

Iodine

Question 20

How does brain atrophy appear on CT?

Answer 20

Dilation of ventricles and subarachanoid space

Question 21

what is the origin of the word Tomography?

Answer 21

Tomos - cut

Question 22

In what color does CSF appear on MRI T-2 weighted?

Answer 22

White

water is white

https://www.youtube.com/watch?v=ka-HBXP5ERA

Question 23

Looking at MRI you see:
CSF appears black it can be

Answer 23

FLAIR or T-1 weighted

Question 24

Looking at brain MRI, looking at the sulcus, outside is grey, and inside is white, what is the weighting?

Answer 24

T1

“like normal brain”

Question 25

Best way to do MRI for anatomic details of the head?

Answer 25

T1 weighted with contrast

Question 26

What is the contrast agent used when we do **MRI T1** weighted with **contrast**?

Answer 26

Gadolinium

Question 27

What is the relevancy of T2-weighted MRI imaging in the head?

Answer 27

CNS pathologies, since they tend to accumulate water | T2 it's an image of the water content

Question 28

Why do we use MRI or CT in dementias?

Answer 28

To exclude secondary forms (hematomas/neoplasms)

Question 29

What do we see in primary forms of dementia on CT/MRI?

Answer 29

Signs of atrophy (dilation of ventricles)

Question 30

Why do we use PET/SPECT for dementias?

Answer 30

To differentiate different forms of dementia | Alzheimer- reduced function of parietal frontal cortex

Question 31

what do we see on CT when lookin for parkinson?

Answer 31

usually it's negative

Question 32

How does **Parkinson's disease** appear on **MRI**?

Answer 32

**Atrophy** of the *compact part* of the **substantia nigra**

Question 33

What are some uses of FLAIR in brain imaging?

Answer 33

To detect *atrophy*, *white matter plaques*, and *demyelination*.

Question 34

Imaging used in acute phase (Trauma) of injury and later it's monitoring?

Answer 34

MRI and CT

Question 35

When is it beneficial for to use Multi detector CT?

Answer 35

Very useful in **Polytraumatic patient**

Question 36

What is the appearance of post-traumatic **hemorrhage** lesions on ***CT***, in **respect to normal tissue**?

Answer 36

Hyperdense

Question 37

What is the appearance of post-traumatic **edema** lesions on ***CT***, in **respect to normal tissue**?

Answer 37

*Hypodense*

Question 38

After three days since the head trauma, what is the imaging of choice?

Answer 38

CT | especially for the hemorrgic component

Question 39

Carotid-cavernous fistulas (CCF) can form in skull base fractures. In these cases, the 1st level investigation is?

Answer 39

ANGIO-CT

Question 40

**Angio-CT** is done with contrast?

Answer 40

yes

Question 41

do we use contrast agent in **Angio-MR**?

Answer 41

No!!!

Question 42

Imaging for movement disorders?

Answer 42

MRI ## Footnote Among the most frequent is certainly Parkinson's disease (caused by a dysfunction of the nigrostriatal dopaminergic system

Question 43

In parkinson's disease, CT is usually negative or positive?

Answer 43

Negative ## Footnote Unless there is associated cerebrovascular disease

Question 44

How do we see **Parkinson's** disease on **MRI**?

Answer 44

Show signs of **atrophy** and **thinning/disappearance** of **PARS COMPATTA** of SUBSTANTIA NIGRA.

Question 45

What can be the use of **PET/SPECT** in **movement disorders**?

Answer 45

with dopaminergic tracers can show **reduced dopaminergic function** of the **putamen** and **caudate** basal nuclei.

Question 46

What is the **imaging** indicated in **cognitive deterioration, Dementia**?

Answer 46

**CT** or **MRI**

Question 47

What can allow us an *early diagnosis* of **Alzheimer's disease**?

Answer 47

**Atrophy** of the ***unco-hippocampal region*** can be highlighted with **MRI** ## Footnote The measurement of the volume of this region with segmentation techniques seems to be able to allow an early diagnosis of the disease

Question 48

What is the use of **PET** and **SPECT** in different types of dementias?

Answer 48

Used as **2nd level techniques** to highlight functional alterations that **allow differentiating different forms of dementia**

Question 49

What functional deficits we see in Alzheimer's disease?

Answer 49

**Temporo-parietal association cortex** that extend over time to the **frontal** one ## Footnote With sparing of the primary sensorimotor cortex, the basal nuclei and the cerebellum.

Question 50

what deficits we see in frontotemporal dementias?

Answer 50

**Frontotemporal lobe** functional deficits

Question 51

What part of the brain in **dementia with Lewy bodies** is reduced?

Answer 51

Occipital activity

Question 52

on **PET/SPECT** what area of the brain it's activity is impaired in **Huntington's chorea**?

Answer 52

**Heads of the caudate nuclei**