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Flashcards in this deck (60)
  • The introduction to neuroradiology is presented by Steven Romero, MD.

    neuroimaging introduction presenter
  • The presenter is a PGY-2/R1 in Diagnostic Radiology at UMKC.

    neuroimaging education radiology
  • The presenter has no potential conflict of interest in relation to this presentation.

    disclosure ethics
  • The objectives include a brief review of imaging techniques employed for neuroimaging.

    objectives neuroimaging techniques
  • One objective is to identify vessels from the Circle of Willis on MRA.

    objectives circleofwillis mra
  • The differences between noncommunicating and communicating hydrocephalus should be understood.

    objectives hydrocephalus differences
  • Neuroimaging provides images of the head/neck/spine via noninvasive techniques.

    neuroimaging overview techniques
  • There are two types of imaging: Structural imaging and Functional imaging (EEG, PET, fMRI, etc.).

    imaging types overview
  • Common imaging techniques include CT, CT Angiogram, Cerebral Angiography, MRI, MRA, and MRV.

    imaging techniques overview
  • Hounsfield Units are a range of CT numbers from -1000 to 3000 used to assign value to different attenuation, with water as 0.

    ct physics hounsfieldunits
  • Cerebral angiography uses the same principles and techniques as traditional interventional radiology.

    angiography techniques interventionalradiology
  • In MRI, T1 shows CSF as dark and fat as bright, good for anatomy.

    mri t1 anatomy
  • In MRI, T2 shows CSF as bright and fat as bright, good for pathology.

    mri t2 pathology
  • DWI detects random movements of water protons, good for stroke.

    mri dwi stroke
  • ADC is needed to confirm stroke.

    mri adc stroke
  • A 52 year old male presented to ED with right-sided weakness and numbness that first started 2 days ago.

    case stroke symptoms
  • The most appropriate initial test for stroke suspicion is CT head without contrast.

    case stroke diagnosis
  • CT findings for ischemic stroke include loss of grey/white differentiation, dense vessel sign, and insular ribbon sign.

    ischemicstroke ct findings
  • Hypodensity (vasogenic edema) in the area corresponds to the neuro deficit.

    ischemicstroke ct hypodensity
  • Old infarcts can make diagnosis difficult, usually presenting as areas of encephalomalacia.

    ischemicstroke diagnosis infarcts
  • Usually, CTA head/neck and CT perfusion are also obtained.

    ischemicstroke cta ctperfusion
  • A 78 year old male with a history of dementia presented to the ED after being found on the floor with unknown LOC.

    case dementia loc
  • The most appropriate initial test for the 78 year old male is CT head without contrast.

    case dementia diagnosis
  • Subdurals over time can show changes in CT scans.

    subdurals ct findings
  • Acute/subacute changes can occur on chronic subdurals.

    subdurals ct changes
  • An epidural hematoma is an accumulation of blood in the epidural space, commonly from rupture of the middle meningeal artery.

    medical neurology hematoma
  • Acute epidural hematoma is associated with trauma, lucid interval, and rapid expansion of blood leading to a decline in the patient's condition.

    medical neurology hematoma
  • CT findings of epidural hematoma show biconvex hyperdense blood products that do not cross suture lines.

    medical neurology ct
  • The treatment for epidural hematoma can be surgical evacuation or conservative management with repeat CT scans.

    medical neurology treatment
  • An aneurysm is an abnormal dilation of an artery due to weakening of the vessel wall.

    medical neurology aneurysm
  • A case of a 84 year old male with altered mental status may indicate a need for a head CT to evaluate his condition.

    medical neurology diagnosis
  • The diagnosis options for the 84-year-old male's condition include: A. Normal head CT, B. Normal pressure hydrocephalus, C. Obstructive hydrocephalus, D. Ex-vacuo dilatation, E. Colloid cyst.

    medical neurology diagnosis
  • Hydrocephalus is characterized by dilation of the ventricles due to increased volume of CSF.

    medical neurology hydrocephalus
  • In communicating hydrocephalus, the treatment is ventricular shunt placement.

    medical neurology treatment
  • In noncommunicating hydrocephalus, the treatment involves surgical removal of tumor.

    medical neurology treatment
  • Ex vacuo dilation is the appearance of increased CSF due to decreased brain parenchyma (atrophy), with normal ICP and no treatment necessary.

    medical neurology diagnosis
  • A 26-year-old woman with sore throat, pain while swallowing, shortness of breath, and fever may require a CT Soft Tissue Neck evaluation.

    medical neurology diagnosis
  • A 78 year old male with lung cancer and altered mental status may require an MRI HEAD WITH CONTRAST for further evaluation.

    medical neurology diagnosis
  • Meningitis and HSV Encephalitis are types of infections that can affect the central nervous system.

    medical neurology infection
  • A 37 year old female with unilateral gradual onset monocular visual loss and a swollen optic disc may be diagnosed with multiple sclerosis.

    medical neurology diagnosis
  • Multiple sclerosis is the most common disabling CNS disease in young adults, more commonly affecting women in their 20s/30s.

    medical neurology disease
  • Multiple sclerosis involves autoimmune inflammation and demyelination of the nervous system.

    medical neurology disease
  • The most common disabling CNS disease in young adults is Multiple Sclerosis.

    neurology disease multiple_sclerosis
  • Multiple Sclerosis more commonly affects women in their 20s/30s.

    neurology demographics multiple_sclerosis
  • Multiple Sclerosis is characterized by autoimmune inflammation and demyelination.

    neurology disease multiple_sclerosis
  • Patients with Multiple Sclerosis can present with optic neuritis, INO, hemiparesis, sensory deficits, and bladder/bowel dysfunction.

    neurology symptoms multiple_sclerosis
  • A clinical feature of Multiple Sclerosis is the Charcot triad.

    neurology symptoms multiple_sclerosis
  • The clinical course of Multiple Sclerosis is typically relapsing and remitting.

    neurology clinical_course multiple_sclerosis
  • For stroke and head trauma, a non-contrast CT is always required to assess for hemorrhage.

    radiology ct stroke
  • A non-contrast head CT is good for assessing stroke, hemorrhage, trauma, and hydrocephalus.

    radiology ct diagnosis
  • CTA and MRA are needed to assess vessels for dissection and aneurysms.

    radiology cta mra
  • An MRI head is valuable for assessing infections, tumors, and demyelinating diseases.

    radiology mri diagnosis
  • In MRI, protons are like little magnets that respond to a Radio Frequency pulse.

    radiology mri nmr
  • Once protons are knocked out of alignment, they begin to precess and gradually realign with the magnetic field.

    radiology mri nmr
  • Protons echo back the radio frequency that originally tipped them over, forming the basis of the MRI image.

    radiology mri nmr
  • In the context of CT imaging, acute blood is typically measured at 60 to 90 Hounsfield units.

    radiology ct imaging
  • Simple fluid is measured at -10 to 20 Hounsfield units in CT imaging.

    radiology ct imaging
  • The anterior cerebral artery can be seen on CT imaging as right and left branches.

    radiology ct anatomy
  • The middle cerebral artery is also visible on CT imaging as branches on the left and right.

    radiology ct anatomy
  • Subdural collections in CT can be classified as hypodense, isodense, or hyperdense.

    radiology ct subdural