Random Flashcards
Vanishing tumor of the brain
One scan it’s there
Next scan not there
Lymphoma
Pt having a partly solid partly cystic lesion in the cerebellum with contact with pial surface
Raised hematocrit
RAISED HEMATOCRIT
POLYCYTHEMIA
——> hemangiblastoma
Women with breast cancer
Develops tongue weakness
Herniating of tongue with deviation on protrusion
Hypoglossal canal metastases
(If pt presents with loss of taste in the post aspect of the tongue, vocal cord paralysis, dysphasia, weakness of sternocleidomastoid and trapezius- jugular foramen involvement -vernet syndrome)
Child with developmental delay
1.mri brain shows basal ganglia calcification with hydrocephalus
2. Mri brain shows periventriculad calcification with polymicrogyria
- Toxoplasmosis
- CMV
Clover leaf skull seen where?
CAT
Croydon
Apert
Thanotophoric dysplasia(more commonly shows macrocephaly with a large anterior fontanelle)
Enlarged phalangeal tufts and metacarpals
Deepening of voice
Spade like phalanx
Acromegaly
Pituitary a demons
Which is NOT true regarding MS?
A. The T1 lesion load including enhancing lesions or black holes is correlated more closely than T2 lesion load with clinical outcome
B. Brain atrophy is higher in MS than normal ageing. Brain atrophy in MS usually appears as enlarged ventricles and reduced size of the corpus callosum. Significant loss of white matter rather than grey matter is seen in the early stage of MS
C. The pattern of brain atrophy can mimic Alzheimer’s disease
D. Occult tissue damage is detected by DTI showing reduced fractional anisotropy (representing microstructural damage)
E. MS lesions have low MTR (Magnetisation Transfer Ratio) representing myelin loss
C is wrong
Malignant melanoma of brain
Can also present in military form
Subependymal nodules
Moderate to intense enhancement
Or hypoenhancing necrotic areas
Prominent perilesional edema
Multiple lesions in grey white matter junction
If present in abdomen
Most common site- small bowel
Liver mets can be single or multiple and maybe partly calcified not completely
Larger lesions are mostly necrotic
May mimic lymphoma
A 67 year-old man has been rushed to the stroke unit with features of acute stroke. All of the following are true about acute stroke imaging, except
A. CT source images correlate with infarct volume.
B. Matched CBV (Cerebral blood volume) and CBF (Cerebral blood flow) represent salvageable brain.
C. Diffusion-weighted MR imaging assesses the infarct core.
D. Mismatch between PWI (Perfusion weighted imaging) and DWI (Diffusion weighted imaging) volumes represents salvageable brain.
E. T2 shine through is seen as bright on DWI
B,
CBF, CBV and MTT can distinguish infarcted tissue from potentially salvageable brain
Aneurysms based on location
Anterior chiasmatic cistern
ACOM
Septum pellucidum
ACOM
Anterior interhemispheric fissure
ACOM
Prepontine cistern
Basilar artery
Foramen magnum
Anterior pericallosal cistern
PICA ACA, ACOM
Sylvian fissure
Intraventricular
MCA, ICA, РСОМ
MCA, ICA, ACOM
A 40-year-old man was punched in the face during an altercation. Clinical examination showed left facial swelling with left-sided ophthalmoplegia and diplopia. X-rays showed a left maxillary fracture. What is the likely cause of the patient’s symptoms?
A. Superior orbital fissure syndrome
B. Cavernous sinus thrombosis
C. Carotico-cavernous fistula
D. Post-traumatic ophthalmoplegia
E. Cerebral venous sinus thrombosis
Because the upper transverse maxillary buttress forms the orbital floor, fractures of this buttress may cause various orbital complications, including inferior rectus muscle tears, globe rupture or impingement, optic nerve injury and orbital hematoma.
Superior orbital fissure syndrome is caused by extension of the fracture through the superior orbital fissure, with resultant injury to cranial nerves III, IV, VI (the ophthalmic branch of the trigeminal nerve) and VI as they traverse the fissure into the orbit, thus causing ophthalmoplegia or diplopia (extra-ocular muscle paralysis) and ptosis (paralysis of the levator palpebrae superioris, which is supplied by cranial nerve III). Additional injury to the optic nerve (cranial nerve Il) at the orbital apex results in orbital apex syndrome, with unilocular visual loss added to the list of signs and symptoms. Orbital apex syndrome is a surgical emergency because prompt intervention is necessary to prevent permanent blindness.
DNET VS MULTINODULAR VACUOLATING NEURONAL TUMOR(MVNT)
Mvnt vs dnet
- subcortical white matter vs cortical white matter
- no bright flair rim vs white flair rim present
Intensely enhancing homogenous solid periventricular mass lesion with restricted diffusion and thallium positive on SPECT
Ass with ebstein Barr virus in 90% cases
Cns lymphoma
headaches, seizures (including epilepsy), and stroke-like symptoms
DSA-
the absence of early venous drainage
absence of shunt
large areas of parenchymal involvement, often an entire lobe or even a hemisphere is affected
the nidus (which may be lobar or hemispheric) is fed by multiple arteries with an absence of a dominant arterial feeder
feeder arteries tend to be of normal size or moderately enlarged, including development of flow-related aneurysms
stenoses of feeder arteries is often present
classical nidus appearance with scattered “puddling” of contrast which persists into the late arterial and early venous phases
the nidus usually has a fuzzy appearance and is not well-circumscribed
Ans-cerebral proliferative angiopathy.
The absence of early venous drainage, which helps to differentiate cerebral proliferative angiopathy from a classical brain AVM
Bell’s palsy and Ramsay hunt which segment of facial nerve enhances
Canalicular segment in iac
Otosclerosis types affects which window
1. Fenestral
2. Retrofenestral
- Anterior to oval window , the footplate of stapes will fuse to oval window. Can have conductive hearing loss
- Retro-fenestral- more severe, demineralization around the cochlea. Sensorineural hearing loss. Affects round window.
Large vestibular aqueduct
With
Sensorineural hearing loss
Pendred syndrome
Enlargement of aqueduct>1.5mm
Cochlear hypoplasia also can cause large aqueduct
Superior semicircular canal dehiscense
Noise induced vertigo
Tullios phenomenon
Otitis media
Retro orbital pain
Abducens nerve palsy(due to abscess in petrous apex- petrous apicitis)
Gradenigo syndrome
Pt with cerebellar ataxia and spinothalamic tract involvement
Pica/ vertebral artery infarction in lateral medullary syndrome aka wallenburg syndrome
Infarction of lateral portion of medulla
Can also present with ipsilateral horners syndrome or hiccoughs
Ipsilateral loss of pain and temperature of face
C/L for the rest of the body
Ipsilateral bulbar symptoms
