Neuro

Question 1

Although CT is more widely used, what XR views are needed for C-spine?

Answer 1

AP
Lateral
Odontoid view

Question 2

What does CT detect better than MRI?

Answer 2

blood

Question 3

What is better about MRI in the skull base?

Answer 3

no bony artifacts

Question 4

What do we look for symmetry on odontoid view?

Answer 4

lateral masses aligned

margins of medial C1 lateral mass with the odontoid

Question 5

How big is the soft tissue in front of C2? C7?

Answer 5

7mm

20mm

Question 6

what is wackenheim’s line?

Answer 6

Line extending posteriorly from the clivus

Normally is tangential to or intersects the posterior 1/3 of the dens. Means skull base is in proper alignment with C1 C2

Question 7

What is a chance fracture?

Answer 7

• Common flexion injury secondary to seatbelt use in high speed MVA.
• Fracture through posterior elements and vertebral body.
• High incidence of concomitant abdominal organ injury

Question 8

what do we look for in hemorrhagic contusions on MR?

Answer 8

gradient sequence

blooming

Question 9

Loss of normal gray/white junction density difference is suggestive of what?

Answer 9

Stroke

Question 10

Narrowed ventricle and asymmetry we should think?

Answer 10

mass effect like subdural hematoma

Question 11

what does clotting blood look like on non-contrast CT?

Answer 11

bright

Normal bright structures include:
Bones
Choroid plexus
Pineal Gland
Falx calcifications

Question 12

What is T1 good for? what color is CSF? what color is grey compared to white? What color is fat?

Answer 12

anatomy
CSF is dark
Grey darker than white
Fat is bright

Question 13

What is T2 good for? what color is CSF? what color is grey compared to white? What color is fat?

Answer 13

pathology
CSF is bright
gray matter is brighter than white
fati is kind of bright

Question 14

what is different about flair?

Answer 14

normal fluid is dark T2, but pathologic fluid of any abnormality is bright

Question 15

what is diffusion good for?

Answer 15

stroke/abscess

Question 16

in diffusion what is the CSF color? what is normal brain parenchyma?

Answer 16

dark

low in signal intensity

Question 17

What does bright on diffusion equal?

Answer 17

restriction

acute stroke, abscess, blood, tumor

Question 18

DIFFUSION FINDING MUST BE WHAT COLOR ON ADC TO BE REAL?

Answer 18

DARK

Question 19

what is gradient good for?

Answer 19

blood

Question 20

gradient looks like washed out T2, what makes blood bloom?

Answer 20

ferromagnetic substances

Question 21

T1 with contrast is good for pathology, what kind of stuff enhances?

Answer 21

SQ tissues, Muscles, choroid plexus, arteries and veins

normally, brain parenchyma does not enhance

Question 22

What are the early CT findings of stroke

Answer 22

obscuration of basal ganglia
hyperdense artery
loss of grey white differentiation
effacement
mass effect

Question 23

Does epidural hematoma cross suture?

Answer 23

no

Question 24

what doesn’t subdural hematoma cross?

Answer 24

falx nor tentorium

Question 25

when do we see rebleed acute on chronic subdural hematomas? what do they look like?

Answer 25

child abuse or elderly who keep falling multiple lines of bleed and clot

Question 26

where does SAH blood settle?

Answer 26

Blood settles into the sulci, basilar cisterns, and ventricles

Question 27

With SAH what two things should we consider if no trauma?

Answer 27

AVM or aneurysm

Question 28

what is the bleeding difference between intraparenchymal hemorrhage and diffuse axonal injury

Answer 28

intraparenchymal are contusions with largery bleeds, DIA is tiny hemorrhages located at the grey-white junction and in the deep white matter

Question 29

Magic Dr.

Answer 29

``` mets abscesses gliomas infarct- subacute not acure contusion demylineation resolving hematoma ```

Question 30

can an epidural hematoma cross the falx?

Answer 30

yes

Question 31

what is the line from clivus through dens?

Answer 31

wackenheim's line- if anterior means A-O dislocation

Question 32

what is the fracture of C1 called?

Answer 32

jefferson's

Question 33

what does diffuse brain edema look like?

Answer 33

gray white looks all homogenized