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Neuroradiology Differentials (copy)

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Persistent embyronic ICA to vertebrobasilar connections
trigeminal (#1)
hypoglossal
otic
proatlantic artery
Intraaxial hemorrhage
HTN (#1)
tumor, trauma
AVM/aneurysm
coagulopathy, amyloid angiopathy
emboli
hemorrhagic infarction
vasculitis
Aneurysm
(class by shape)
saccular - degen, trauma, mycotic, vasculopathy

fusiform - atherosclerotic

dissecting - trauma > vasculopathy > spontaneous
SAH
aneurysm (#1)
trauma
AVM
coagulopathy
extension of parenchymal bleed
idiopathic
spinal AVM
Vascular malformations
AVM
capillary telangiectasia
cavernous malformation
venous anomaly
vein of Galen AVM or varix
Stroke - causes
atherosclerosis
cardiac emboli
arterial dissection, vasculopathy
IVDA
venous thrombosis
blood dyscrasias
Venous sinus thrombosis
pregnancy
dehydration
infection
tumor
hypercoagulable state
trauma
Primary brain injury
epidural hematoma
SDH
subdural hygroma
DAI
cortical contusion
Secondary brain injury
cerebral herniation
diffuse cerebral edema
arterial diss (spont, trauma, HTN, vasculopathy, migraine, IVDA)
CCF
Extraaxial masses (hemisphere)
meningioma
mets
lymphoma
arachnoid cyst
dermoid/epidermoid
fluid (blood or pus)
hemangiopericytoma
Extraaxial masses (clivus/prepontine cistern)
meningioma
mets
chordoma
chondrosarcoma
Intraaxial masses (hemisphere)
astrocytoma / GBM
oligodendro/ganglio -glioma
lymphoma
mets
PNET and DNET
Intraaxial masses
(sella)
adenoma
craniopharyngioma
Rathke’s cyst
mets
abscess
sarcoid
EG stalk
Intraaxial masses
(brainstem)
astrocytoma
GBM
Intraaxial masses
(pineal region)
germinoma
teratoma
pineocytoma
pineoblastoma
Intraaxial masses
(cerebellum)
astrocytoma
medulloblastoma
hemangioblastoma
mets
ependymoma
choroid plexus papilloma
Intraaxial masses
(temporal lobe in young patient)
ganglioglioma
DNET
JPA
PXA
Multiple lesions
TUMOR
mets, GBM, lymphoma

INFECTION
abscess, fungus, cysticercosis, toxo

VASCULAR
embolic infarcts, multifocal bleed, DAI, contusions, cav. hemangiomas, vasculitis
Corpus callosum lesions
TUMOR - GBM, lymphoma, lipoma, mets (rare)

DEMYELINATING - MS, ADEM, PML

INFARCT- always involves cingulate gyrus

TRAUMA- DAI
Intrasellar masses
pituitary adenoma
apoplexy
craniopharyngioma
Rathke’s cyst
mets
aneurysm
abscess
lymphocytic hypophysitis
Suprasellar masses
(mnemonic full list)
SATCHMOE -
- Sellar lesion / sarcoid
- Aneurysm, arachnoid cyst
- Teratoma
- Craniopharyngioma
- Hypothalamic glioma
- Mets, meningioma
- Optic nerve glioma
- EG, epidermoid/dermoid
Posterior fossa tumors (adults)
mets
hemangioblastoma
astrocytoma
choroid plexus papilloma
meningioma
epidermoid
dysplastic gangliocytoma
Posterior fossa tumors (children)
JPA
medulloblastoma
brainstem glioma
ependymoma
Brain tumor in infant
teratoma (#1)
PNET
choroid plexus papilloma
astrocytoma
Intraventricular tumors (adults)
astrocytoma
subependymoma
meningioma
mets
cysticercosis
CPA mass
SAME

Schwannoma (acoustic)
Aneurysm, Arachnoid cyst
Meningioma, Mets
Epidermoid, Ependymoma
Cystic mass
benign and tumor ddx's
TUMOR - cystic astrocytoma/ GBM, hemangioblastoma, mets, necrotic pituitary adenoma, craniopharyngioma

BENIGN - epidermoid/dermoid, arachnoid cyst, porencephalic cyst, colloid cyst, cavum variants, Rathke’s cyst, thrombosed aneurysm
Diffuse infiltrative
lymphoma
gliomatosis cerebri
white matter disease
Restricted diffusion
infarct
infection
possibly subacute hemorrhage
Metastasis (intraaxial)
lung
breast
colon
melanoma
Metastasis (extraaxial)
breast
lymphoma
prostate
neuroblastoma
Brain metastasis (hemorrhagic)
melanoma
renal
chorioCA
thyroid
Tumors with CSF seeding
choroid plexus papilloma
ependymoma
PNET (medulloblastoma)
pineoblastoma
germinoma
GBM
Hyperdense lesion on CT
lymphoma, medulloblastoma/PNET
ependymoma, germinoma, GBM
hemorrhagic or mucinous mets
osteogenic tumor
hemorrhage, aneurysm
meningioma, colloid cyst
Calcified intraparenchymal lesions
--oligodendroglioma, ependymoma, mucinous adenoCA, osteogenic sarcoma
--toxo, CMV, cysticercosis, TB
--AVM, aneurysm, TS, Sturge-Weber, hematoma

sellar lesions - meningioma, craniopharyngioma, germ cell tumor, aneurysm
T2 hypointense lesions
ferritin, hemosiderin, deoxyhemoglobin, intracellular methemoglobin

melanin, calcification, fibrous tissue, high protein concentration

lymphoma, myeloma, neuroblastoma, meningioma, flow void
T1 hyperintense lesions
Gd
methemoglobin, melanin, certain states of calcium
fat (dermoid)
high protein concentration (colloid cyst)
slow flow
Differential of choroid plexus mass
Papilloma
Carcinoma
Hemangioma
Xanthogranuloma
Metastasis
Lesions with strong enhancement
meningioma
medulloblastoma/PNET
paraganglioma
HIV-associated lymphoma
GBM
AVM / aneurysm
Ring enhancement
GBM, mets, lymphoma
Infarct, contusion, bleed (resolving)
Abscess, AIDS
RTX
Demyelinating disease
Diffuse meningeal enhancement
meningitis
carcinomatosis (lymphoma,mets)
post-op
SAH
intracranial hypotension
CSF leak
Basilar meningeal enhancement
INFECTION - TB (#1), fungal, pyogenic (more common on convexity), cysticercosis

TUMOR - lymphoma, leukemia, carcinomatosis

INFLAMMATORY- sarcoid, rheumatoid pachymeningitis, drugs, pantopaque, ruptured dermoid
Ependymal enhancement
TUMOR - lymphoma, mets, CSF seeding (PNET, GBM)

INFECTION- spread of meningitis, CMV (rare)

INFLAMMATORY- ventriculitis (postshunt or after instrumentation), posthemorrhage
T2 hypointense basal ganglia lesions
old age
any degenerative dz(MS, Parkinson’s)
childhood hypoxia
T2 hyperintense basal ganglia lesions
-TUMOR- lymphoma, NF
-ISCHEMIA- hypoxic encephalopathy, venous infarct
-NEURODEGENERATIVE dz (uncommon), Leigh’s dz
-TOXIN- CO, CN, H2S, hypoglycemia, methanol
-INFECTION- Crypto, parasites
T1 hyperintense basal ganglia lesions
dystrophic Ca++(any cause)
hepatic failure
NF
manganese
Basal ganglia calcification
- Physiologic (#1)
- Hyperparathyroidism
- TORCH, AIDS, TB, toxo, cysticercosis (common)
- Lead, CO, RTX, chemo
- Fahr’s disease
- Mitochondrial (common)
- Ischemic-hypoxic injury
White matter disease
-DEMYELINATING (MS, ADEM, CPM)
-DYSMYELINATING Leukodystrophies
-TUMOR (lymphoma, mets)
-INFLAMMATORY (Lyme, sarcoid, HIV, PML, CMV)
-VASCULOPATHY (sm vessel ischemia, vasculitis, HTN, eclampsia, migraines, RTX, chemo, cyclosporine, IVDA)
Wallerian degeneration
infarction
trauma
demyelinating
radiation
neurodegenerative
tumor
Neurodegenerative disorders
WM - demyelinating, dysmyelinating

GM - Alzheimer’s, Pick’s, multiinfarct dementia, Parkinson’s, lysosomal storage disorders, Wernicke’s, Creutzfeldt-Jakob, mesial temporal sclerosis

BG - Huntington’s, Wilson’s, Fahr’s, Leigh’s, ALS
Cerebellar atrophy
oligopontocerebellar degeneration
alcohol
dilantin
hemosiderin deposition
Noncommunicating hydrocephalus
Foramen of Monro obstruction:
3rd V mass, colloid cyst, oligodendroglioma, central neurocytoma, SEGA, ependymoma, suprasellar mass

aqueduct obstruction:
cong aqueductal stenosis, ventriculitis, IVH, tumor (mesencephalic, pineal, post 3rd ventr)

4th ventricle obstr:
DW malf, IVH, infection, subependymoma, exophytic brainstem glioma, posterior fossa mass
Communicating hydrocephalus
meningitis (infectious, carcinomatous), SAH, surgery, venous thrombosis; NPH
Cystic supratentorial congenital anomalies
holoprosencephaly, hydrancephaly, aqueductal stenosis, callosal dysgenesis, porencephaly, arachnoid cyst, cystic teratoma, epidermoid/dermoid, vein of Galen AVM
Posterior fossa cystic abnormalities
- DW malformation (vermian hypo/aplasia and large post fossa)
- DW variant (normal post fossa and vermian hypoplasia)
- megacisterna magna (nl vermis)
- retrocerebellar arachnoid cyst (must show mass effect)
- Chiari 4 (near complete absence of cerebellum)
- epidermoid/ dermoid
- cystic tumor
- Joubert’s syndrome (superior vermian hypo/aplasia)
- rhomboencephalosynapsis (vermian hypo/aplasia + fusion)
Absent septum pellucidum
holoprosencephaly
ACC
septooptic dysplasia
Chiari 2
Migration and sulcation anomalies
lissencephaly, schizencephaly, polymicrogyria, pachygyria, cortical heterotopia (focal, diffuse, subependymal), hemimegalencephaly
Phakomatoses
NF
-I :fibromas, CN2 gliomas, sphenoid dysplasia
-II :MISME, bilat CN8 neuroma
TS
-Hamartomas, Tubers, SEGA, WM lesions;
+renal, bone, lung dz
VHL
-hemangioblastomas (cerebellum, stem, retina), renal (CA+cysts), adrenal (pheo), pancreas (cysts, CA, islet tumors)
Sturge-Weber
-tram-track Ca++ of cortex, leptomeningeal angiomas (p>o>f lobes), big choroid plexus
Diffuse marrow involvement
mets, myeloma
lymphoma, leukemia
anemia
Paget’s
FD
Spinal cord compression
criteria
- no CSF around cord, AP diam (<7mm), cord deformed

causes
- infection (TB, pyogenic)
- compression fx(CA, trauma)
- spondylosis /disk dz (HNP, hypertrophy of ligaments, osteophyte, FJD)
- primary bone d/o(Paget’s)
- epidural hematoma
Spinal lesion

Intramedullary
TUMOR
-astrocytoma (#1), ependymoma (#2)
-hemangioblastoma, lymphoma, mets (rare)
DEMYELINATING dz/myelitis
SYRINX
AVM
TRAUMA(contusion)/ RTX
sarcoid
Spinal Lesion:

Intradural extramedullary
-nerve sheath tumor (#1)
-meningioma, mets (drop)
-lipoma, teratoma
-arachnoid cyst
-arachnoiditis/meningitis
-AVM/AVF
Spinal lesion

Extradural
-Disc disease (fragment, discitis)
-mets, lymphoma
-epidural abscess or hematoma
-lipomatosis (thoracic)
-synovial cyst
extramedullary hematopoiesis
Tarlov cyst
Syrinx
Primary:
- Chiari malformations
- spinal dysraphism
- Dandy-Walker
- diastematomyelia

Acquired:
- tumor (astrocytoma, ependymoma)
- trauma (spinal cord injury, vascular insult)
- inflammatory (arachnoiditis/ meningitis, SAH)
External auditory canal
exostoses, malignant otitis externa, atresia
Clivus mass
chordoma
chondrosarcoma
plasmacytoma
mets, lymphoma
FD
EG
Petrous apex mass
cholesterol granuloma
mucocele
petrous apicitis
epidermoid
mets, myeloma
chondrosarcoma
meningioma
aneurysm
Soft tissue mass in middle ear
cholesteatoma
cholesterol granuloma
glomus tympanicum tumor
aberrant ICA
high or dehiscent jugular bulb
Intracanalicular IAC masses
exclusively intracanalicular
- acoustic neuroma
- facial neuroma
- hemangioma
- lipoma

not primarily intracanalicular
- meningioma
- epidermoid
Hearing loss
conductive
- otitis media
- cholesteatoma
- otosclerosis
- trauma (longitudinal fx)

sensorineural
- idiopathic hereditary
- acoustic neuroma
- trauma (transverse fracture)
Pulsatile tinnitus
aberrant ICA, jugular bulb anomalies, glomus jugulare, glomus tympanicum, AVM, ICA aneurysm at petrous apex
Jugular fossa mass
glomus jugulare (#1), NF (#2), schwannoma, chondrosarcoma, mets
Orbital masses by etiology
tumor
lymphoma, mets (neuroblastoma, breast), lymphangioma, rhabdomyosarc, hemangiopericytoma, neurofibroma, dermoid

inflammatory
pseudotumor, thyroid ophthalmopathy, cellulitis, abscess, Wegener’s

vascular
carotid-cavernous fistula, venous varix, thrombosis of superior ophthalmic vein, hemangioma (old: cavernous; kids: capillary)

trauma
hematoma, FB, lens dislocation
Extraconal disease in the orbit
* Nasal dz: infection, cancer

* Orbital bone dz: subperiosteal abscess, osteomyelitis, FD, tumors, trauma

* Sinus dz: mucocele, invasive infections, neoplasm

* Lacrimal gland dz: adenitis, lymphoma, pseudotumor, tumor
Intraconal disease
well-defined margins - hemangioma, schwannoma, orbital varix, meningioma

ill-defined margins - pseudotumor, infection, lymphoma, mets

muscle enlargement - pseudotumor, Graves’, myositis, carotid-cavernous fistula
Vascular orbital lesions
tumor -
hemangioma, lymphangioma, hemangioendothelioma, hemangiopericytoma, meningioma, hypervascular mets

vascular (enlarged sup ophthalmic vn) - carotid cavernous fistula, cavernous thrombosis, orbital varix, ophthalmic artery aneurysm
Optic neuritis
abnormal T2 signal and enhancement but not enlarged - MS, sarcoid, infection
Optic neuropathy
abnormal T2 signal only - compression, ischemia, pharmacologic, toxins, trauma
Optic nerve tumor
* glioma
* meningioma

abnormal T2 signal and enhancement and nerve enlarged
Optic nerve sheath enlargement
TUMOR- CN2 glioma, meningioma, meningeal carcinomatosis, mets, lymphoma, leukemia
INFLAMMATORY- optic neuritis, pseudotumor, sarcoid
increased ICP
TRAUMA- hematoma
Tramtrack enhancement of orbital nerve
optic nerve meningioma
optic neuritis
idiopathic
pseudotumor
sarcoid
lymphoma, leukemia
perioptic hemorrhage
mets
normal variant
Ocular muscle enlargement
thyroid ophthalmopathy (#1, painless)
pseudotumor (painful)
infection from adj sinus
TB, sarcoid
carotid cavernous fistula
hemorrhage
Orbital mass in a child
LO VISON

Leukemia
Optic nerve glioma
Vascular (hemangioma)
Inflammation
Sarcoma, rhabdomyosarcoma
Ophthalmopathy/pseudotumor
Neuroblastoma
Adult orbital masses
hemangioma
schwannoma
melanoma
meningioma
lymphoma
pseudotumor
trauma
Cystic orbital lesions
dermoid, epidermoid, teratoma, ABC, cholesterol granuloma, colobomatous cyst
T1 hyperintense orbital masses
tumor - melanoma, retinoblastoma, choroidal mets, hemangioma; detachment - Coat’s disease, persistent hyperplastic primary vitreous, trauma; other - hemorrhage, phthisis bulbi
Globe calcifications
tumor - retinoblastoma (95%), astrocytic hamartoma (TS, NF), choroidal osteoma

infection (chorioretinitis) - toxoplasmosis, herpes, CMV, rubella

other - phthisis bulbi (ca++ in endstage dz, shrunken bulb), optic nerve drusen (most common cause calcifs in adults, bilateral)
Micropthalmia
persistent hyperplastic primary vitreous, retinopathy of prematurity, congenital rubella, phthisis bulbi
Sudden onset proptosis
orbital varix, hemorrhage into cavernous hemangioma or lymphangioma, CCF, thrombosis of superior orbital vein
Lacrimal gland enlargement
benign lymphoid hyperplasia, pseudotumor, sarcoid, Sjogren syndrome, pleomorphic adenoma, adenoid cystic CA, lymphoma, leukemia, dacryoadenitis
Diffuse bone abnormality
FD, Paget’s, thalassemia, osteopetrosis, craniometaphyseal dysplasia, mets
Radioopaque sinus
normal variant - hypoplasia, unilateral thick bone

sinusitis (acute w AFL; chronic w thick mucosa and ret cysts) - allergic, aspergillosus, mucor, sarcoid, Wegener’s

solid masses - SCC, polyp, inverted papilloma, lymphoma, juvenile angiofibroma (most common tumor in children), mucocele (expansile, a/w CF in kids), esthesioneuroblastoma, mets, osteoma, FD

postsurgical - Caldwell-Luc
Mucosal space mass
SCC, lymphoma, rhabdomyosarcoma, melanoma, adenoids, juvenile angiofibroma, Thornwald’s cyst
Parapharyngeal and carotid space masses
salivary gland tumors (80% benign), vagal schwannoma, cervical sympathetic plexus schwannoma, glomus vagale, nasopharyngeal CA, lymphadenopathy, abscess, cellulitis
Prevertebral mass
mets, chordoma, osteomyelitis, abscess, hematoma
Sublingual space mass
lymphangioma, ranula, hemangioma, lingual thyroid, inflammatory
Simultaneous sublingual and submandibular space mass
diving ranula, lymphangioma, abscess
Post-styloid parapharyngeal mass
salivary tissue, nerves, nodes, glomus tumor
Prestyloid parapharyngeal mass
pleomorphic adenoma, Warthin’s, mucoepidermoid, adenoid cystic, branchial cleft cyst, neurogenic tumor, hemangioma, node
Bilateral parotid low attenuation lesions
HIV lymphoepithelial cysts
Sjogren’s
Warthin’s tumor
infection
Enlarged parotids
obesity, DM, alcohol, cirrhosis, malnutrition, drugs
Sialoliths
sarcoid, Sjogren’s, HPT
Cystic extrathyroid lesions
NECK:
* branchial cleft cyst (lat to carotid)
* thyroglossal duct cyst (midline)
* ranula (retention cyst of sublingual glands)
* retention cysts of mucous glands (parotid)
* cystic hygroma (lymphangioma, most common < 2y/o)

NASOOROPHARYNX:
Thornwald’s cyst, mucus retention cyst, necrotic SCC

LARYNX & PARALARYNGEAL:
laryngocele, mucus retention cyst
Cystic thyroid lesions
colloid cyst, cystic degeneration, cystic papillary tumor, cystic mets
Bilateral thyroid masses
lymphoma, mets (RCC, lung), multiple primary tumors, MNG, thyroiditis, cysts
Neck lymphadenopathy
enlarged Waldeyer’s ring - lymphoma, mononucleosis, HIV

skin lesions - KS, sarcoid, lymphoma, CA, cat-scratch, TB, Actinomycosis

enlarged nodular salivary glands - HIV, Sjogren, sarcoid, lymphoma, cat-scratch

calcified - thyroid CA, treated lymphoma, sarcoid, silicosis, TB
Solid neck mass
SCC of larynx or nasooropharynx, lymphadenopathy, parotid tumor, neurofibroma, glomus tumor, dermoid, teratoma, infection, granulomatous inflammation, ectopic thyroid
Vascular head and neck mass
glomus - carotid body, vagale, jugulare, tympanicum
hemangioma
AVM
aneurysm (often ICA) - pseudoaneurysm, posttraumatic
Vocal cord paralysis
tumor, post-op, iatrogenic, idiopathic
AIDS -
what are the ENT complications?
ENT complications in 50%

parotid - multiple intraparotid cystic masses (benign lymphoepithelial lesion), lymphadenopathy

sinonasal - sinusitis, KS

oral cavity - Candida, periodontal an gingival infections

pharynx/larynx - opportunistic infections, epiglottitis, lymphoma

temporal bone (rare) - otitis media, otitis externa
Odontogenic
cysts, ameloblastoma, odontogenic carcinoma or sarcoma; nonodontogenic - osteosarcoma, chondrosarcoma, Ewing’s, myeloma
Intraventricular mass
(child)
choroid plexus papilloma
ependymoma
medulloblastoma
teratoma
astrocytoma
Intraventricular mass
(lateral ventricle)
age 0-15:
-PNET -choroid plexus papilloma

Age 15-30:
-glioma -JPA

Over 30:
-subependymoma
-astrocytoma
-mets
-oligodendroglioma
-meningioma
-central neurocytoma
Intraventricular mass
(3rd ventricle)
Age 0-15:
- astrocytoma
- EG of stalk
- germinoma
- extrinsic craniopharyngioma

Age 15-30: - colloid cyst

Over 30:
- glioma - mets
- pituitary or pineal mass
- Other (aneurysm, sarcoid)
Intraventricular mass
(4th ventricle)
age 0-15:
- ependymoma
- medulloblastoma

age 15-30:
- choroid plexus papilloma

Over 30:
- mets
- hemangioblastoma
- subependymoma
basal ganglia bright on T1
Hypo and pseudohypoparathyroidism
HyperPTH
Hallervordin-Spatz
Hyperalimentation
Hemorrhage
CO
NF
What are the nodal stations of the neck?
Lvl I Submental(A)/submand(B)
Level II- Upper IJ
Level III- Middle jugular
Level IV - Low jugular
Level V- Posterior triangle
- A- Above cricoid arch
- B- Betw arch & clavicle
Level VI- Upper visceral
Level VII- Sup mediastinal
Progression of hematoma
Age/stage
main component
T1 and T2 signal
<1d___oxyhemoglobin____Lo__Hi
0-2d__deoxyhemogl______Lo__Lo
2-14d_intracel methem__Hi__Lo
10-21d_extracel methem_Hi__Hi
>21d___hemosiderin_____Lo__Lo
Suprasellar mass ddx
adults vs. pedi
adults
--macroadenoma (#1)
--meningioma
--glioma
--craniopharyngioma
--aneurysm

children
--craniopharyngioma (#1)
--glioma
--germinoma
--hypothalamic hamartoma
--EG
Causes of orbital inflammation
Orbital cellulitis

Mucormycosis

Graves

Orbital pseudotumor

Sarcoidosis

Wegener's granulomatosis
Skull base tumors
Chordoma
Chondroma/Chondrosarcoma
Plasmacytoma
Paraganglioma
Nerve sheath tumors
Cholesteatoma
Mets
Posterior fossa tumor in adult
intra-axial
1. Metastasis (lung, breast)
2. Hemangioblastoma
3. Lymphoma
4. Lipoma
Posterior fossa tumor in adult
extra-axial
"hit in head with a MACE:
Meningioma
Acoustic neuroma
Chordoma/Choroid papilloma
Epidermoid
intramedullary spinal mass ddx

- with basic MR signal for each
Ependymoma: mix T1, hi T2

Astrocytoma: iso-loT1, iso-hiT2

Hemangioblastoma: lo T1, hi T2
(also w cysts and flo voids)

Mets: iso T1, iso-hi T2
(gray nodule with edema)
Intradural (but extramed) spinal mass ddx

- with basic MR signal for each
Meningioma- iso T1, var T2
Neurinoma- iso T1, hi T2
Neurofibroma- iso T1, mix hiT2
Lipoma- hi T1, lo T2
Mets- iso T1, iso-hi T2
Extradural spinal mass ddx

(with basic MR signal for each)
* Mets: lo T1, mild hi T2
* Epidermoid: lo T1, hi T2
* Lymphoma: iso T1, iso-hi T2
* Lipoma(/tosis): hi T1, lo T2
* Teratoma: mix T1 and T2
"Other" spinal mass ddx

- with MR signal
Arachnoid cyst - lo T1, hi T2
Chordoma- iso T1, mix T2
Arthopathic pseudotumor- iso-lo on both
DDx
Intraventricular mass
T1 Dark
T2 Bright
Non-enhancing
Arachnoid cyst
Cysticercosis
Colloid cyst (3rd vent)
Cystic crangiopharyngioma
Cystic meningioma
DW cyst (4th vent)
Epidermoid (4th vent)
Neuroepithelial cyst
DDx
Intraventricular mass
CSF signal
Arachnoid cyst
Cysticercosis
DW cyst or variant
Mega cisterna magna
DDx
Intraventricular mass
T1 Dark
T2 Dark
Enhancing
Acute hematoma
Calcified SEGA
Calcified glomus of choroid plexus
Dense or calcified mets (colon, prostate)
Meningioma with Ca++
DDx
Intraventricular mass
T1 bright
T2 dark
Colloid cyst
CSF flow
Dermoid
Early subacute bleed
Craniopharyngioma (calcifed)
Lipoma
Pantopaque
Xanthogranuloma of choroid
DDx
Intraventricular mass
T1 bright
T2 bright
Dermoid
Flow
Intraventricular craniopharyngioma
Late subacute bleed
Infratentorial Pediatric Neoplams

DDx
JPA
Brain stem astrocytoma
Medulloblastoma/PNET
Ependymoma
Other
medullomyoblastoma
rhabdoid
anaplastic ependymoma

Differential for nodular meningeal enhancement
* Infect granulomatous dz (TB, fungal)
* Inflammatory meningitis (sarcoid)
* Lymphoid (lymphoma, plasmacytoma)
* Carcinomatous meningitis
* Meningioma
Differential diagnosis of a calcified brain mass:
Adults
o Meningioma
o Oligodendroglioma
o Aneurysm / AVM
o Calcified Tuberculoma
Children/Adolescents
o Giant Cell Astrocytoma
o Ependymoma
o Ganglioglioma
o AVM
Differential Diagnosis for a midline, clival-centric mass:
o Chordoma
o Chondrosarcoma
o Epidermoid

o Meningioma
o Rhabdomyosarcoma
o Nasopharyngeal tumors
o Plasmacytoma
o Lymphoma

Deck Info

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