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NEURORADIOLOGY DDx


SALIVARY LESIONS
Cysts - lymphoepithelial,=20 branchial
Sialadenitis
Pleomorphic Adenoma
Warthins = Tumor
Adenoid=20 Cystic - cylindroma
Mucoepidermoid

SINSUS LESIONS
Aplasia = or=20 Hypoplasia - should be seen by 6, adult by 15
Mucocele
Inverting=20 Papilloma
Squamous Cell Ca
Juvenile=20 Angiofibroma
Ameleoblastoma
Infection - Sinusitus,=20 mucormycosis
Wegeners - septal erosion

SKULL LESIONS "help=20 me"
Hemangioma
EG
Leptomeningeal Cyst
Pagets
Mets &=20 Myeloma
Epidermoid

RETROPHARYNGEAL THICKENING
R/O = redundancy -=20 image in extention
Abcess
Cystic=20 Hygroma
Rhabdomyosarcoma
Trauma

LACRIMAL GLAND=20 LESIONS
Pleomorphic Adeoma
Adenoidcystic=20 Ca
Lymphoma
Pseudotumor
Dermoid
Mets

OCULAR=20 LESIONS
Retinoblastoma
Persistent Hyperplastic Primary Vitreous -=20 embryonic vasc hyaloid
Coat's Dz - lipoprotienacious flued behind=20 retina
Retrolental Fibrosis - oxygen toxicity, calc can sim=20 retinoblastoma
Melanoma
Drusen - hyaline & calc of optic=20 disk
Detachment
Infection - toxacara canis

CONAL = LESIONS
Graves=20 - bilat, painless
Pseudotumor - unilat,=20 painful
Lymphoma
Mets
Glioma
Meningioma
Infection -=20 surgical
Varix

RING ENHANCEING LESION - "magic=20 dr"
Mets
Abcess
Glioma
Infarct
Contusion
Demyelinating = Dz
Resolving Hematoma

ABCESS vs METS
Daughter = Lesions
Sharper=20 Inner Margin
Thicker Towards Cortex

CONGENITAL = INFECTIONS
CMV -=20 central calc
Toxoplasmosis - peripheral calc
Ruebella - = both
Herpes -=20 none
Varicella
H. flu - subdural hygroma

AIDS RELATED CNS=20 DZ
Toxoplasmosis
HIV Encephalopathy
Progressive Multifocal=20 Leukoencephalopathy - papova virus
I' CNS = Lymphoma

DEMYELINATING=20 DISEASES
Multiple Sclerosis
Aquired Disseminated=20 Encephalomyelitis
Progressive Multifocal Leukoencephalopathy - papova = virus
Toxic - Etoh, Wernicke's, osmotic = myelinosis
Trauma
Vascular -=20 PVL, necrotizing leukoencephalopathy, Binswanger's, = SLE

DYSMYELINATION=20 DISORDERS
Metachromatic Leukodystrophy - lysosomal, deep confluent, = hypo=20 thalami
Krabbe Dz - lysosomal, deep confluent, hyper thalami,=20 rapid
Adrenoleukodystrophy - post to ant
Alexander's Dz - = inclusions, ant=20 to post
Canavan's Dz - spongy degen, U fibers 1st
Amino Acid = Deficiency -=20 phenylketonuria, maple syrup urine, homocystinuria

DIFFUSE AXONAL = INJURY
Corticomedullary Junction - frontal, temporal
Corpus = Callosum -=20 post body & spenium
Pons & Dorsal Midbrain

VASCULAR=20 COLLATERALS
Circle of Willis
Ophthalmic
Meningeal

MRI = STAGES OF=20 HEMORRHAGE
T1 T2
Hyperacute <6hrs iso Bright = Oxyhemoglobin
Acute=20 7-72hrs iso Dark Deoxyhemoglobin
Early Subacute 3-7d Bright Dark=20 Methemoglobin still in RBC
Late Subacute 1-4wks Bright Bright = Methemoglobin=20 diluted extracellular
Chronic >4wks Dark Dark Hemosiderin
CT = STAGES OF=20 HEMORRHAGE 4
Hyperacute - 2-3hrs, isodense
Acute - 3hrs to 2wks,=20 hyperdense (60-100HU, dec by 1.5HU/d)
Subacute - 2-4wks, = isodense
Chronic=20 - >4wks, hypodense

PARENCHYMAL=20 HEMATOMA
Trauma
Hypertention
Infarct
Aneurysm
AVM
Tumor=
Bleeding=20 Diathesis
Amyloid

SKULL BASE=20 LESIONS
Chordoma
Chondrosarcoma
Squamous=20 Cell
Schwannoma
Meningioma
Mets
Glomus

POSTERIOR = FOSSA MASS=20 IN A CHILD
Medulloblastoma - hyperdense, no calc
Ependymoma - = plastic,=20 calc
Pilocytic Astrocytoma - cyst & nodule
Brainstem=20 Glioma

POSTERIOR FOSSA MASS IN AN = ADULT
Mets
Hemangioblastoma - 20%=20 w = VHL
Subependymoma
Infarct/Hemorrhage
Abcess

CEREBELLOPONT= INE=20 ANGLE MASS
Schwannoma - 7/8, vest of VIII 75%, facial=20 4%
Epidermoid
Arachnoid Cyst
Meningioma

CEREBELLAR=20 DYSPLASIA'S
Cebellar atrophy
Chiari IV Malformation
Joubert's = Syndrome=20 - split vermis
Rhomboencephalosynapsis - absent = vermis
Tectocerebellar=20 Dysraphia - hypoplastic vermis, cb rotated ant lat to = stem
Lhermitte-Duclos=20 Dz - gangliocytoma

PINEAL TUMORS
Germinoma - 60%, dense, = placental alk=20 phos
Teratoma - both
Choriocarcinoma - B-hcg
Endodermal Sinus = Tumor -=20 alpha-fetoprotien
Embryonal Cell Carcinoma -=20 both
Pineocytoma
Pineoblastoma

SELLAR REGION=20 MASS
Aneurysm
Adenoma
Craniopharyngioma
Chordoma
Meningiom= a
Hamartoma=20

INTRAVENTRICULAR MASS
Ependymoma
Meningioma - atria(#1), = trigone,=20 encysted temporal horn
Choroid Plexus Papilloma
Giant Cell = Astrocytoma -=20 TS
Colloid Cyst
Epidermoid Cyst

COATING OF SPINAL = CORD
Drop=20 Mets
Lymphoma
Sarcoid

EXTRADURAL SPINAL CORD LESIONS = 8
Osteoid=20 Osteoma
ABC
EG
Chondrosarcoma
Chordoma
L Mets &=20 Myeloma
Vascular

INTRADURAL EXTRAMEDULLARY CORD=20 LESIONS
Neurofibroma
Meningioma
Dermoid
Arachnoid=20 Cyst
Mets

INTRAMEDULLARY CORD LESIONS
Ependymoma -=20 myxopapillary
Astrocytoma
Hemangioblastoma
Infection
Infarct<= BR>
BASAL=20 GANGLIA & THALMUS LESIONS - bilat & sym
Methanol - putamen = very=20 sensitive
Carbon Monoxide - globus pallidus
Hypertention - = Hematoma, must=20 be long standing
Glioma
Cushing's Reflex - any mass will cause HTN = acutely

NF-2 "mis=20 me"
Multiple
Inherited
Schwannoma
Meningioma
Ependymoma
LARGE=20 FLUID FILLED HEAD
Hydrocephalus - macrocephaly
Hydrancephaly -=20 normocephaly
Holoprosencephaly - microcephaly

CONGENITAL GRAY = MATTER=20 NEURODEGENERATIION
Lipodoses - Tay-Sach's
Mucopolysaccaroidosis -=20 Morquio's, Hurler's
Glycogen Storage Dz - Pompe's

CONGENITAL=20 NEURODEGENERATION OF BOTH GRAY & WM
Mitochondrial - Leigh's, = MERRF,=20 MELAS
Peroxisomal - Zellwenger's
Basal Ganglia - Huntington's, = Fahr's,=20 Wilson's

METS THAT HEMORRHAGE (MR, CT)
Melanoma
Renal=20 Cell
Choriocarcinoma
Thyroid

STROKE EVOLUTION
Hyperacute = -=20 <12hr, inc T2 at 8hr
Acute - 12-48hrs, sulci efface, meninges=20 enhance
Subacute - 2d-2wks, max mass effect at 5d, parenchymal = enhance at 4d,=20 dec T2
Chronic - gliosis & vol loss =1A