Glossary of T2 Katz Neuro Test 2
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- What cause lentiform nucleus obscuration and when can it be seen?
- Cytotoxic edema in basal ganglia. It indicates proximal MCA occlusion-->so limited flow to lenticulostriate arteries.
-Seen as early as 1 hr post stroke onset.
- What is the most consistent sign of infarction?
- Diffuse hypodensity & sulcal effacement.
- What does parenchymal hypodensity in greater than 50% of of MCA indicate?
- 85% mortality rate
- Wht does hypodensity in greater than 1/3 of MCA indicate?
- It a contraindication to thrombolytic therapy b/c of high incidence of hemorrhage.
- What are the findings of a subacute infarction that 1-3 days old on CT?
- -Increasing mass effect
-Wedge shaped low density
-Hemorrhagic transformation (dry to wet infarct)
- What are the findings of a subacute infarction in 4-7 days on CT?
- -Gyral enhancement
-Persistent mass effect
- What are the findings of a subacute infarction on CT in 1-8 wks?
- -Mass effect resolves
-Enhancement may persist.
- What three factors cause enhancement in infarctions?
- 1. breakdown of BBB
3. reperfusion of damaged brain tissue
- What are two types of extra-axial infections?
- 1. Meningitis
2. Subdural & Epidural infections
- What are the three subtypes of meningitis?
- 1. Acute pyogenic meningitis-->usually bacterial
2. Lymphocytic meningitis-->usually viral, benign, & self-limited.
3. Chronic meningitis-->often in immunocompromised hosts, may be fungal or parasite.
- Is imaging usually performed for meningitis?
- -Its not performed to diagnose meningitis b/c imaging can turn out nl even w/ disease, but can be used in those suspected to assess safety of LP.
- What types of conditions can lead to an abnormal increase of CSF in CNS?
- cerebral atrophy & focal destructive lesions.
- Which type of hydrocephalus is most common?
- Communicating hydrocephalus, aka nonobstructive. Its caused by impaired CSF resorption in absence of any CSF-flow obstruction-->maybe dysfunctional arachnoid granules along superior sagittal sinus.
- What are three causes of obstructive hydrocephalus?
- aquuductal stenosis or occlusion, trapped 4th ventricle, ependymitis
- 50% of extra-axial infections are associated w/ what condition?
- Sinusitis, usually frontal. Occurs by direct extension or septic thrombophlebitis.
- What usually causes subdural empyemas?
- meningitis, sinusitis, trauma, or prior surgery.
- Which condition is an uncommon cause of cerebral infarction but its important b/c of its morbidity? Presents w/ HA & cranial nerve palsies
- Venous thrombosis
- What % of AIDS patients get neuro complications?
- What are the most frequent causes of CNS complications in AIDS pts?
- toxoplasmosis (10-33%)
primary CNS lymphoma (2-10%)
- What do CNS complications in AIDS pts appear like on CT?
- hypodense masses w/ nodular or ring enhancement.
- What 4 things will appear dark on T1 & T2?
- calcifications, bone, air, slow flowing blood.
- How do intracranial tumors present?
- w/ focal neurological deficit, seizure, or HA.
- Which intr-axial tumor is 50% of all primary CNS neoplasms?
- Describe the grading system for astrocytomas.
- -Grade I: benign or low grade
-->lack necrosis & endothelail proliferation
Grade II: same as above.
Grade III: anaplastic
-increased cellularity &
mitosis & pleomorphism
Grade IV: malignant --Glioblastoma --marked necrosis & endothelial proliferation.
- What is the most aggressive grade of astrocytoma and what is its 2-yr survival rate?
- Glioblastoma Multiforme, 10-15% survival.
- Which lesion frequently crosses the corpus callosum?
- Glioblastoma Multiforme.
- What is the most common intracranial tumors in adults?
- Metastasis: 35-50% of intracranial tumors.
- What is the order of frequency of metastatic brain tumors (high to low)?
- lung, breast, melanoma, renal, Colon CA.
- How do CT & MRI correspond to one another in metastatic cancer to the brain?
- Patient should do contrast enhanced CT & then followup by contrasted MRI.
-20% of pts who demonstrate a single lesion on CT may demonstrate multiple lesions on MRI.
- Where do half of primary brain tumors in children originate?
- posterior fossa;
- What percent of pts w/ medulloblastoma have CSF dissemination at diagnosis?
- What is the most common extra-axial neoplasm of the brain & who is most affected?
- Meningiomas. Middle-aged women.
- What are the advantages of CT scanning in imaging meningiomas?
- -can see calcification of meningiomas.
-invasion of surrounding dura frequently provokes an osteoblastic reponse, causing hyperostosis.
-Can show acute tumor hemorrhage & widened vascular grooves in calvarium.
- Are pituitary adenomas benign or malignant?
- Almost always benign, w/ no malignant potential.
- What is the most common demyelination disease & what is the usual age of onset?
- MS, 3rd-4th decade.
- What imaging technique should be used for MS?
- What are typical locations for MS lesions?
- periventricular white matter, brainstem, cerebellum, spinal cord.
- What is the most common white matter lesion?
- Ischemic demyelination, after age 60.
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