Imaging Spotter Pathology Flashcards
(176 cards)
1
Q
What appearance does a subdural haematoma have on CT?
A
-cresent shaped, thin layer of blood covering large area
2
Q
What about an extradural haematoma?
A
-limited tracking due to cranial suture lines so biconvex shape
3
Q
Damage to what often causes subdural haematomas?
A
-bridging veins connecting superficial cortical surface to the superior sagittal sinus
4
Q
What people are at more risk or subdural haematoma?
A
- people who fall
- brain atrophy e.g. alcholics, elderly, dementia
5
Q
What is the Nissl stain used to demonstrate?
-the large “Nissl bodies” represent..
A
- neuronal cell bodies e.g. the 6 layers of cortex
- represent aggregates of rough ER (ie. high protein synthesis and high MR)
6
Q
Selective frontal lobe atrophy with cognitive decline is indicitive of…
A
fronto-temporal dementia
7
Q
What developmental anomly consists of a tangle of arterial and venous channels of differing sizes?
Symptoms? Phenomenon?
A
- AVM- Arterio-Venous Malformation
- seizures, headaches, brain haemorrhage/focal neurological deficits
- steal phenomenon=fast flow from arterial to venous blood channels so steals blood from the surrounding brain tissue
8
Q
What would cause a dilation of one lateral ventricle?
A
-monoventricular hydrocephalus due to foramen of monro blocking CSF outflow
9
Q
What risks are associated with ventriculoperitoneal (VP) shunts? What can be done instead?
A
- infection, brain haemorrhage, often fail so need shunt revision
- fenestration of septum pellucidum
10
Q
What is the centrum semiovale
In what condition is it deymyelinated?
What is preserved
A
the central white matter of the hemisphere on axial cut
- metachromatic leukodystrophy
- subcortical U fibres preserved
11
Q
subcortical U fibres supply is by
A
penetrating cortical vessels
12
Q
a well-defined mass pressing on brain from “outside” relating to orbitofrontal cx is likely a …
A
an olfactory groove meningioma (may cause personality change and behavioural disinhibiton)
13
Q
What exits the foramen ovale?
What makes the point of the exlamation mark with this?
A
V3 - mandibular
foramen spinosum is point, this is for the MMA
14
Q
What tract projects from thalamus through sagittal stratum to occipital lobe?
Based on its origin/termination what is it aka..
A
Optic radiations
aka geniculo-calarine tract
15
Q
A large tumour, irregular margin, diffusely invading brain tissue, ring enhancing lesion is likely a
A
malignant glioblastoma
ring enhancing as tumours blood vessels lack a BBB so contrast medium leaks here
16
Q
Abnormal hyperintensity of the pulvinar and mediodorsal nuclei of both thalami is know as the what sign?
What is it suggestive of?
A
The hockey stick sign
Suggests Creutzfeldt-Jacob prion Disease or spongiform encephalopathy
17
Q
The carotid canal holding ICA is where?
Where does the ICA then pass through, which CNVI?
A
- petrous portion of temporal bone
- then through the carotid sinus
18
Q
What tract runs from the occipital to temporal pole?
Which visual steam is this associated with?
A
ILF-inferior longitudinal fasiculus
-ventral stream/”what” pathway
19
Q
Occulusion of PICA commonly causes which syndrome? CNs affected?
Sypmtoms
A
- lateral medullary/Wallenburg’s
- post to olive CNS (IX, X, XI)
- dysphonia, dysphagia, hoarse voice, bovine cough…
20
Q
Why does medial medullary s. of Dejerine cause contra loss of vibration/proprioception (+CNXII palsy and contra hemi)
A
due to damage to medial lemniscus that runs from front to back in the medial meddula
21
Q
What does the internal granule cell layer (IV) recieve? Where is it prominent?
A
- recieves subcortical ascending projections from the thalamus
- prominent in sensory areas (V1, A1, S1)
22
Q
What sign indicates an early hemispheric stroke?
A
The insula ribbon sign
-grey-white distinction of insular cx is reduced on affected side
23
Q
What visual field defect may you expect to see with a lingual gyrus lesion?
A
-a contralateral superior quadrantanopia
24
Q
What is Von Hippel-Lindau Syndrome (VHL)? What is a common finding in the cerebellum appearing as a cystic lesion with a mural nodule?
A
- VHL is associated with tumour and cyst formation in parts of body
- cerebellar haemangioblastoma is common (this is highly vascular and benign)
25
What is another possible cerebellar cystic lesion with an enhancing mural nodule?
A pilocytic astrocytoma
26
What is the Golgi silver stain good for demonstrating?
-neuronal processes (axons+dendrites)
27
What is LFB (Luxol Fast Blue) stain used for demonstrating?
-white matter, so will show clearly if an area is demyelinated (paler)
28
What may bright white spots in postcapillary venules adjecent to CSF spaces indicate on a T2-FLARE scan.
- MS, common in middle aged females
| - white spots are inflammatory demyelination
29
Where does the dentato-rubro-thalamic pathway project through to reach...
Through SCP to reach VL nucleus of thalamus, pars caudalis
30
A rupture of a Charcot microaneurysm affecting the lateral lenticulostriate artery on CT..
..basal ganglia haemorrhage centered on putamen.
| -fresh blood is hyperdense (bright white)
31
What are the features of SMA syndrome? NB only affects voluntary motion
- reduced spontaneous movements
| - difficulty performing voluntary motor acts to command contra limbs
32
Explain subfalcine herniation
- lesion causes midline shift
- medial frontal lobe is pushed under the free edge of the tentorium
- +effacement of lat ventricle
33
Irregular ring enhancing lesion in temporal lobe with cerebral oedema on MRI is likely not to be a glioblastoma, but an
abcess, infection from middle ear roof thin bone (tegmen tympani)
34
SLF 3 is the arcuate fasiculus part, what is it involved in?
- language
| - as connects Broca's to Wernicke's
35
How would you treat an aneurysm at the top of the basilar artery?
-endovascular coiling via interventional radiography
36
A uniform unilateral subtle lesion on insula with no expansion/distortion in a young person is likely a
low grade glioma - benign
37
What is the Band of Giacomini in the uncus hippocampus a part of?
Part of the dentate nucleus
38
Post-ressus from cardiac arrest, MRI infarct between MCA and ACA territories is a
watershed infarct, caused by any profound drop in arterial BP
39
What structure lies within the petrous portion of the temporal bone? Innervated by CNVIII, which terminates where
- the cochlea
| - CNVIII cochlear part terminates in the dorsal and ventral cochlear nuclei of the meddula
40
Where are the dorsal and ventral cochlear nuclei of the meddula found specifically
on the anterior and posterior surfaces of the restifrom body/ICP
41
Bifucation of basilar artery leads to which 2 vessels
L and R PCA
42
Electrodes of DBS to treat idiopathic Parkinson's disease are placed where?
-subthalamic nuclei
43
What may a signal change in a coronal MRI of the hypothalamus (above mamillary bodies) be caused by?
Wernicke's encepalpathy
| e.g. alcoholics/vit B1-thiamine deficiency
44
What is the pathogenesis of a cerebellar stroke due to a vertebral artery dissection?
- traumatic tearing of lining of vertebral artery
| - leads to occlusion due to thrombus formation
45
Reduced dopamine release in caudate nucleus and putamen (but not globus pallidus) is indicitive of
idiopathic parkinsons disease
46
A well-circumscribed rounded lesion, very vascular with a "blush of cappilaries" on angiogram is likely
-a meningioma (extra-axial)
| These are typically attached to the dura
47
Fresh blood in the basal cistern is likely a
- subarachnoid haemorrhage
| - due to ruptured berry aneurysm in circle of Willis
48
Superior Fronto-Occipital Fasiculus (SFOF) course
from frontal, lateral to head of caudate, inf to radiations of corpus callosum, to occipital lobe
49
What round cystic lesion may present in the insula...?
-a cavernous haemangioma
50
The developmental abnormality, harmartoma, may occur ....
| and lead to....
in the hypothalamus
| ..leading to gelastic seizures
51
What does the inferior anastomotic vein of Labbe connect?
-the superficial middle cerebral vein to the transverse cerebral sinus
52
Anterior part of falx cerebri is a common site of origin for what tumour?
Meningiomas
53
What is missing in Urbach-Witte disease? What is it replaced by? Symptoms
No amygdala, replaced with calcium.
| Lack anxiety and fear
54
3rd ventriculostomy to treat hydrocephalus placed..
-in the tuber cinereum (thinnest, most membranous) part of floor, space is opened here for CSF to drain out
55
CNV arises from the juction of basal pons and MCP. From which p. arch does it derive?
- from the 1st/mandibular pharyngeal arch
| - gives rise to upper and lower jaws + muscles
56
the cingulum bundle is the main association pathway of the
limbic lobe
57
The dorsal cingulum lies
under the cinguate gyrus
58
The ventral cingulum lies
under the parahippocampal gyrus
59
The anterior group of thalamus projects to the cingulate cx in which circuit?
Papez circuit, involved in memory
60
Lobule 7 of cerebellum has which 3 cognitive functions
-language, working memory, visuospatial reasoning
61
What does the superior anastomotic vein of Trolard connect?
-the superficial middle cerebral vein to the superior sagittal sinus
62
Where does the superficial middle cerebral vein drain into? 2 sinuses
the sphenoparietal and cavernous sinuses
63
Where does the corticospinal tract cross the midline?
- at inf boarder of medullary pyramids at the cervicomedullary junction
- at level of foramen magnum
64
neocerebellum is which lobe?
posterior
65
What is the name of the mouth embryologically that gives rise to Rathke's pouch?
The stomodium
66
intensity refers to MRI scans, what does density refer to?
CT scans
67
What do the lateral ventricles look like in agenesis of the corpus callsoum? What bundle is seen next to them?
The lat. ventricle is like viking helmet horns
| The bundles of Probst
68
In children, what tumour has rosenthal fibres present?
Pilocytic astrocytoma
69
What brain tumour does VHL (on chromosome 3) predispose you to?
Haemangioblastoma
70
What stain is used as a marker for astrocytes?
GFAP
71
What tumour is commonly found blocking the IV foramen of Monro which causes acute high intercranial pressure leading to drop attacks?
Colloid Cyst
72
The paracentral lobule is vertically above...
the splenium of CC
73
Vascularisation of a tumour generally indicates...
malignancy
74
Glioblastomas are ring enhancing, grade 4 common in middle age, can cross white matter. Whereas astrocytoma..
astrocytoma.. are present more in younger people
| can cause fits
75
Pineoblastoma vs pineocytoma
Pineoblastoma-bad, calcifies
| Pineocytoma - benign
76
What are pineal germ cell tumours called? What do they secrete?
Germinoma
| Release tumour markers eg hCG..
77
What does hydrocephalus ex vacuo mean?
Large ventricles only due to atrophy of brain
78
Huntingtons triple repeat disorder is _ _ _
| Huntingtin is encoded on chromosone #
CAG
| Chromosome 4
79
A hyperintense hippocampus indicates
| This causes
hippocampal sclerosis, causes temporal lobe epilepsy (main cause, followed by low grade glioneuroma)
80
What condition looks like potatos in brain and presents with epilepsy and a facial rash?
Tuberosclerosis
| If all over the place it is called focal corticodysplasia which is due to abnormal brain migration
81
What 2 things could a ring enhancing lesion with oedema be?
- an abcess
| - a glioblastoma
82
What tumour from the lining of ventricles "push" brain and cause gross hydrocephalus?
Apendemoma
83
On a T2 scan how does white matter appear?
Black
84
Paraventricular hyperintensity on a T2 FLARE could be:
- in a young female
- in a child
- in a premature baby
- in a young femal = MS
- in a child = leukoencepalopathy
- in a premature baby = periventricular leukomalacia
85
Infiltrated tumour in tectum is likely a
tectal plate glioma
86
Irregular smooth mass lesion in sella turcica that is non enhancing and non calcified is likely a
pituitary adenoma
| macro>1cm, micro<1cm-secreted hormones, meso
87
Hippocampus atrophies with hydrocephalus ex vacuo in which condition?
Alzheimer's
88
An extra-axial tumour causing midline shift and efacement of lateral ventricle is likely a
meningioma from arachnoid granulation cap cells
| p.s. if you see "whorl" think meningioma
89
periventricular hyperintensity in cuffs of inflammation..are called
Dawson's fingers
90
Cistern in front of pons is the
pontine cistern
91
Tela Chorodia is the lining of the
Velum interpositum
92
Tag on splenium is the
crux of fornix
93
What might an irregular, ring + contrast enhancing lesion that causes midline shift be?
A glioblastoma
94
Where do the following terminate? (ant commisure)
- precommisural fornix
- retrocommisural fornix
- pre goes to septal area in paraterminal gyrus
| - retro goes to mammilary body
95
What eminence is found in the temporal horn of lateral ventricle caused by?
Collateral eminence due to collateral sulcus
96
what feature of the C2 axis is seen on MRI?
Odontoid peg
97
Diffusion weighted MRI appears...
very fuzzy/pixelated
98
What supplies the head of the caudate?
-median striate arteries
99
What are the 4 parts of internal carotid?
- cervical
- petrous
- cavernous with loop de loop/siphon
- supra clinoid
100
What do you called something that is unpaired e.g. abnormal ACA
Azygous (no twin) eg. ACA
101
Superior frontal gyrus on an axial cut does an L shaped turn to become the....
Motor area M1 (precentral gyrus)
102
What does an aneurysm in the Great Cerebral Vein of Galen in a baby cause?
High output cardiac faliure
103
Working memory is area
46
104
Inferior longitudinal fasiculus (ILF) is the ___ visual stream
-ventral visual stream/what pathway
105
What time of tumour often grows in the clivus?
Caudoma
106
Medial lemniscus is for..
..dorsal columns (vibration, proprioception)
107
Neurofibromatosis Type II is a genetic condition, it may predispose you to...
..bilateral neuroma/acoustic schwannomas
108
What vessel lies in the thalamocaudate groove?
Terminal vein
109
The fimbriodentate groove is in the
hippocampus
110
area 28 is entorhinal cx, what is area 35?
perirhinal cx
111
Where is the groove for the superior petrosal sinus?
Petrous ridge of temporal bone
112
Inf petrosal sinus groove runs down
the clivus
113
What sinus is under the lesser wing of the sphenoid bone? What drains here?
The sphenoparietal sinus, the superficial middle cerebral vein drains here
114
What runs in the ambient cistern?
Basal veins of Rosenthal
115
What sinus has its groove in the foramen magnum
Marginal sinus
116
Which sulci lie above gyrus rectus?
-superior and inferior rostral sulci
117
What splits like a wine glass either side of the inf. colliculi?
The lateral lemniscus
118
Which nucleus is in wall of 4th ventricle next to dorsal vagus motor nucleus?
Abducens nucleus which then the nerve runs up to Dorello's canal
119
Which fibres are found in the genu of the internal capsule?
Corticobulbar fibres
120
What vessel may be seen near bunny's face in hippocampus area?
PCA
121
Weigert stains using potassium dichromate to preserve myelin lipids then staining these with haematoxylin, makes...
white matter appear black
122
Pars reticularis of substantia nigra is invisible with eye,it is just anterior to pars compacta and is said to be
displaces internal globus pallidus
| it projects to the superior colliculus
123
The parvocellular neurones of red nuceli project to the
thalamus
124
The magnocellular neurones of red nuceli project to the ... running in the
rubrospinal tract to the neck..
| running in the lateral fasiculus with the spinothalamic tract
125
the central tegmental tract leaves the red nuclei to enter the
(it has the ventral tegmental decussation)
ION of the meddulla
126
The dorsal tegmental decussation is associated with which tract?
Rubrospinal
127
3 parts of elbow in medulla?
- ant. lateral system
- elbow: medial lemnisus (to VPL)
- hand: trigeminal lemnisus (to VPM)
128
Where is the lateral lemniscus's course?
In the inf. collicul -> inf brachium -> MGN -> sublenticular internal capsule -> Heshel's
129
What role does the raphespinal tract have?
-pain gaiting using 5 HT in the substantia gelatinosa (lamina I, II, III)
130
What thin layer is seen thethering the 2 superior cerebellar peduncles?
superior medullary valum
131
What nucleus is around the 4th ventricle in the CNS but is a "ganglion" (normally a PNS structure)
The mesencephalic trigeminal nucleus for jaw proprioception
132
The 2 petrous nerves unite to form the....
| for..
Vidian nerve supplies the nasal mucosa
133
The parasympathetic output of CN 7 and 9 is for the
superior and inferior salivatory nuclei
134
The solitary tract is surrounded by the C shaped nucleus, this lies behind the...
dorsal vagus motor nucleus in the medulla
135
In the area vestibuli, the medial vestibular nucleus appears blocky, how doews the inf. vestibular nucleus appear?
Speckled
136
If you see the ICP with 2 other stuctures resembling a triangle like (putamen, gp ext and gp int) the outer part is the ICP, then..
-the spinal tract of the trigeminal nerve followed by the
-paler nucleus of the spinal tract of the trigeminal nerve
(nucleus has pars: oralis, interpolaris and caudalis)
137
Which nuclei lie on either side of the inf. olivary complex?
Dorsal and medial accessory nuclei of the olive
138
What tract is v. superficial in the lateral medulla?
Ventral spinocerebellar tract
139
What does the central grey surround?
The central cord of the spinal cord
140
Where does the spinal accessory nerve come out?
Ant horn of C1-C5 to the dentate ligament
141
How does Opalski syndrome differ to Babinski-Nageotte?
Lower down
142
What is the facial colliculus syndrome?
- Ipsi CNVI (lateral conjugate gaze palsy)
| - ipsi CNVII palsy
143
Dense MCA sign suggests what?
Ischemic/thrombosis occluding artery
144
What NT does the septal nuclei release?
ACh
145
Semantic FTD (dementia) is loss especially of
lateral temporal lobe so you lose ability to categorise/name things
146
Arterio-venous malformations that cause skin changes e.g. port wine stain (Sterge Weber) would be an example of what kind of condition?
A Neurocutaneous s. (of ectodermal tissue)
| e.g. NFM Type II, tubero sclerosis..
147
Overdrainage of ventricles leads to..
| Risks..
Slit ventricles
- chronic subdural haematoma
- low pressure headaches
148
What is leukodystrophy
AR condition of white matter dysfunction
149
Monro-Kelly doctrine states what?
With a space occupying lesion, intercranial pressure will go up after a point of decompensation
150
Name 3 hot points for meningioma formation:
- petrous ridge
- CPA
- olfactory groove
151
The retrofungal tract goes to the LGN. What tract leaves the LGN to reach the calcarine sulcus?
Geniculocalcarine tract
152
What function is the extreme capsule involved with?
language
153
What are the 6 layers of the cerebral cortex?
| 1) Molecular
2) ext. granule
3) ext pyramidal
4) int. granule
5) int. pyramidal
6) polymorphic
154
A cystic lesion in the medulla with a mural nodule could be .... or ... (both are WHO grade I )
- pilocytic astrocytoma with rosenthal fibres
| - a haemangioblastoma
155
Luxol fast blue is a copper phthalocyanine dye that is attracted in lipoproteins of the ...
Which appears..
myelin sheath. With the stain, myelin fibers appear blue
| nerve cells appear purple
156
What is chromatolysis a part of?
The axon reaction
157
Where does the SCP project to ? (the cerebellothalamic fibres)
The VL pars caudalis of the thalamus
158
What may a subfalcine herniation cause secondarily?
An ACA stroke
159
Most common sites for a Berry Aneurysm (which can cause vasospasm) are:
- Ant comm.
- Trifurcation of MCA
- Post comm
160
What vein runs in the foramen cecum?
Emissary vein
161
Sphenoparietal sinus is contiunous with the
cavernous sinus
162
Amyloid B followed by Tao-neurofibrilary tangles is indicitive of
Alzehimers
163
What is the most common cause of subarachnoid haemorrhage
Berry Aneurysms
164
A slow growing diffuse benign tumour that may cause seizures could be a
low grade glioma
165
What tumours calcify on CT, have fried egg cells and chicken wire blood vessels?
Oligodendrogliomas
166
What non-calcified tumours look like stars/spiders microscopically?
Astrocytomas
167
3 features of insula lobe seizures could include:
- time distortion
- fear
- epigastric rising sensation
168
What is the name for the shark teeth with the fimbria "fringe" attached?
The Denticulate Margin
169
In what condition does the PPN (pedunculopontine nucleus) degenerate?
Parkinson's so can do DBS here
170
What nuclei does the fastigial nucleus project to via the...
The vestibular nuclei via the ICP
171
What occurs in transcortical motor aphasia
non-fluent aphasia with preservation of repitition due to preserved arcuate fasiculus
172
Non dominant lobe Broca damage-->
| Wernicke's damage -->
```
Broca = amusia
Wernicke's = aprosmodia
```
173
What hormone does pineal gland secrete?
Melatonin
174
Pyramis/biventral is lobule number
8 (like bow tie)
175
the caudate and lentiform nuclei collectively are the
dorsal striatum
176
You lose lateral substantia nigra first so you have sparing of the
medial caudate
