Presentation1.pptx. radiological imaging of epilepsy.Abdellah Nazeer
1) Hippocampal sclerosis, characterized by hippocampal atrophy and increased signal intensity on MRI, is the most common epileptogenic abnormality found after epilepsy surgery.
2) Malformations of cortical development, including focal cortical dysplasias and heterotopias, are also common epileptogenic lesions found in surgical series, especially in patients with childhood-onset seizures.
3) In addition to structural abnormalities, low-grade gliomas and hamartomas located near the cerebral cortex are also important causes of drug-resistant epilepsy that may require surgery.
This document provides a differential diagnosis for bilateral abnormalities seen on imaging of the basal ganglia and thalamus. It reviews the anatomy of these structures and then describes various pathologies that can cause bilateral involvement, including toxic poisoning, liver disease, hypoglycemia, hypoxic ischemic encephalopathy, Leigh disease, Wilson disease, osmotic myelinolysis, and others. For each pathology, the causes, clinical features, and imaging findings such as location and appearance on MRI are summarized.
Presentation1.pptx, radiological imaging of peri natal acute ischemia and hyp...Abdellah Nazeer
This document discusses radiological imaging of neonatal acute ischemia and hypoxic ischemic encephalopathy. It describes different types of imaging techniques including CT, MRI, DWI, and ASL and how they can be used to identify areas of injury over time in neonates who experience a stroke. Risk factors for neonatal stroke are also reviewed. Imaging findings include restricted diffusion, cortical laminar necrosis, and reversal of gray-white matter attenuation on CT. MRI is useful for assessing injury to deep gray matter structures and cortical border zones.
This document provides an overview of white matter diseases. It discusses:
1. Primary demyelinating diseases like multiple sclerosis and neuromyelitis optica which are characterized by loss of myelin.
2. Secondary demyelination caused by known etiologies like infections, metabolic disorders, or vascular issues which result in destruction of both axons and myelin.
3. Dysmyelinating/hypomyelinating leukodystrophies which involve defective or incomplete myelin formation, including some common causes like metachromatic leukodystrophy.
4. The clinical approach involves considering features like onset, progression, family history, involvement of other organs, and patterns
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
The document discusses ring enhancing lesions seen on neuroimaging. These lesions appear as hypodense masses that enhance with contrast. Common causes include metastatic lesions, primary brain tumors, pyogenic brain abscesses, tuberculomas, cysticercus granuloma, demyelinating disorders, and opportunistic infections in HIV patients such as toxoplasmosis and primary CNS lymphoma. Differential diagnosis depends on location, size, enhancement pattern and associated findings on imaging and other tests.
Presentation1.pptx, radiological imaging of cerebral venous thrombosis.Abdellah Nazeer
This document provides an anatomical review of the cerebral venous system and discusses radiological imaging techniques for diagnosing cerebral venous thrombosis (CVT). It describes the normal anatomy of cerebral veins and venous sinuses that drain blood from the brain. Computed tomography and magnetic resonance imaging are effective noninvasive methods for identifying CVT. Direct signs on imaging include visualizing thrombus as hyperdense on CT or hyperintense on MRI. Indirect signs include edema, infarction, hemorrhage, and collateral vessel formation caused by venous outflow obstruction from thrombus.
Presentation1.pptx. radiological imaging of epilepsy.Abdellah Nazeer
1) Hippocampal sclerosis, characterized by hippocampal atrophy and increased signal intensity on MRI, is the most common epileptogenic abnormality found after epilepsy surgery.
2) Malformations of cortical development, including focal cortical dysplasias and heterotopias, are also common epileptogenic lesions found in surgical series, especially in patients with childhood-onset seizures.
3) In addition to structural abnormalities, low-grade gliomas and hamartomas located near the cerebral cortex are also important causes of drug-resistant epilepsy that may require surgery.
This document provides a differential diagnosis for bilateral abnormalities seen on imaging of the basal ganglia and thalamus. It reviews the anatomy of these structures and then describes various pathologies that can cause bilateral involvement, including toxic poisoning, liver disease, hypoglycemia, hypoxic ischemic encephalopathy, Leigh disease, Wilson disease, osmotic myelinolysis, and others. For each pathology, the causes, clinical features, and imaging findings such as location and appearance on MRI are summarized.
Presentation1.pptx, radiological imaging of peri natal acute ischemia and hyp...Abdellah Nazeer
This document discusses radiological imaging of neonatal acute ischemia and hypoxic ischemic encephalopathy. It describes different types of imaging techniques including CT, MRI, DWI, and ASL and how they can be used to identify areas of injury over time in neonates who experience a stroke. Risk factors for neonatal stroke are also reviewed. Imaging findings include restricted diffusion, cortical laminar necrosis, and reversal of gray-white matter attenuation on CT. MRI is useful for assessing injury to deep gray matter structures and cortical border zones.
This document provides an overview of white matter diseases. It discusses:
1. Primary demyelinating diseases like multiple sclerosis and neuromyelitis optica which are characterized by loss of myelin.
2. Secondary demyelination caused by known etiologies like infections, metabolic disorders, or vascular issues which result in destruction of both axons and myelin.
3. Dysmyelinating/hypomyelinating leukodystrophies which involve defective or incomplete myelin formation, including some common causes like metachromatic leukodystrophy.
4. The clinical approach involves considering features like onset, progression, family history, involvement of other organs, and patterns
Its important to recognise the myelination pattern in neonates and infants. This presentation talks about the myelination pattern and imaging of white matter diseases in children.
The document discusses ring enhancing lesions seen on neuroimaging. These lesions appear as hypodense masses that enhance with contrast. Common causes include metastatic lesions, primary brain tumors, pyogenic brain abscesses, tuberculomas, cysticercus granuloma, demyelinating disorders, and opportunistic infections in HIV patients such as toxoplasmosis and primary CNS lymphoma. Differential diagnosis depends on location, size, enhancement pattern and associated findings on imaging and other tests.
Presentation1.pptx, radiological imaging of cerebral venous thrombosis.Abdellah Nazeer
This document provides an anatomical review of the cerebral venous system and discusses radiological imaging techniques for diagnosing cerebral venous thrombosis (CVT). It describes the normal anatomy of cerebral veins and venous sinuses that drain blood from the brain. Computed tomography and magnetic resonance imaging are effective noninvasive methods for identifying CVT. Direct signs on imaging include visualizing thrombus as hyperdense on CT or hyperintense on MRI. Indirect signs include edema, infarction, hemorrhage, and collateral vessel formation caused by venous outflow obstruction from thrombus.
This document discusses various toxic and metabolic diseases that can cause abnormalities in the brain. It provides details on liver disease, hypoglycemia, hypoxic ischemic encephalopathy, methanol poisoning, and carbon monoxide poisoning. For each condition, the mechanism and characteristic radiographic findings on techniques such as CT, MRI, T1, T2, FLAIR, and diffusion weighted imaging are described. Bilateral abnormalities are often seen in the basal ganglia, thalamus, and cerebral cortex on imaging for these toxic and metabolic diseases.
Presentation1, radiological imaging of pediatric leukodystrophy.Abdellah Nazeer
This document discusses various pediatric leukodystrophies and white matter disorders that can be evaluated on radiological imaging. It provides descriptions of diseases such as Canavan disease, Alexander disease, Van der Knapp disease, Krabbe disease, GM1 and GM2 gangliosidoses, galactosemia, and Kearns-Sayre syndrome. It discusses the characteristic imaging findings and patterns of involvement for each disease to help with diagnosis. Approaches for evaluating pediatric white matter disorders based on features like macrocephaly, subcortical or deep white matter involvement, and thalamic abnormalities are also outlined.
The document discusses various central nervous system infections, how they can be classified, their routes of entry and imaging appearances. It covers congenital infections including TORCH infections, acquired pyogenic infections such as meningitis, abscesses and ventriculitis. It also discusses viral, parasitic and fungal infections of the CNS. For each type of infection, the causative pathogens, locations, presentations and characteristic imaging findings are outlined.
This document provides an overview of various neuroimaging signs and findings. It describes signs seen on MRI that are characteristic of different neurological conditions. Some examples included are the "eye of tiger appearance" seen in Hallervorden-Spatz disease, the "hot-cross-bun sign" seen in various spinocerebellar ataxias, and the "putaminal slit sign" seen in multiple system atrophy. It also provides images and descriptions of signs seen in conditions like multiple sclerosis, Parkinson's disease, Wilson's disease, tuberculomas, and more. The document serves as a reference for neuroradiologists and neurologists to identify various pathologies based on their imaging appearance.
The document provides information about different MRI sequences and their applications:
- FLAIR sequences suppress the signal from cerebrospinal fluid, highlighting hyperintense lesions near CSF-containing spaces. This makes FLAIR useful for evaluating conditions like multiple sclerosis.
- STIR sequences suppress the signal from fat, making it useful for detecting bone marrow edema which can indicate occult fractures.
- T1-weighted images provide good anatomical details and are best for viewing subacute hemorrhages and fat-containing structures.
Tractography uses diffusion MRI to visually represent nerve tracts in the brain through 3D modeling. It can reveal both long tracts connecting different brain regions and more complex short circuits within the brain. However, nerve tracts are not directly visible through standard imaging techniques. Diffusion MRI measures the directionality of water diffusion within tissues to infer the orientation of fiber tracts. Software then maps the diffusion data to generate color-coded 3D representations of tracts called tractograms. Tractography provides insights into the structure and integrity of white matter pathways in the living brain.
1. The document discusses the anatomy and imaging features of cerebrospinal fluid (CSF) cisterns and spaces. It describes the locations and contents of various cisterns such as the interpeduncular, chiasmatic, crural, ambient and cerebellomedullary cisterns.
2. Imaging findings of different pathological conditions are presented, including benign external hydrocephalus, subdural hematoma, hydrocephalus, atrophy and periventricular leukomalacia. Key distinguishing features between these entities are highlighted.
3. An overview of CSF spaces is given, outlining the appearance of normal, atrophic and edematous/hydrocephalic states.
imaging in neurology - demyelinating diseasesNeurologyKota
This document discusses various demyelinating diseases that can be imaged in neurology. It provides images and descriptions of findings for multiple sclerosis, ADEM, NMO spectrum disorder, Susac syndrome, CLIPPERS, acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, acute necrotizing encephalopathy, and osmotic demyelination syndrome. It compares imaging features of MS and NMOSD that can help differentiate the two conditions. The document also discusses variants of MS like Marburg disease, Schilder disease, and Balo concentric sclerosis.
This document discusses disorders of myelination. It begins by defining myelin and its functions, describing normal myelination milestones. It then covers various white matter disorders including dysmyelination, hypomyelination, and delayed myelination. Specific leukodystrophies are discussed in more detail such as Canavan's disease, Alexander disease, Van der Knapp disease, and glutaric aciduria type 1. Clinical features, imaging findings, and pathology are described for each condition. The document provides an overview of disorders of myelination.
This document discusses imaging in medial temporal lobe epilepsy. It begins by explaining why MRI is important for detecting epileptogenic lesions in refractory cases. It then describes the anatomy of medial temporal lobe structures like the hippocampus and amygdala. The document discusses how hippocampal sclerosis appears on MRI, including features like gliosis, neuronal loss, and atrophy. It also covers other imaging modalities that can help lateralize the seizure focus, such as hippocampal volumetry, relaxometry, MRS, PET, and SPECT. In conclusion, MRI is the best way to diagnose mesial temporal sclerosis by identifying hippocampal hyperintensity and atrophy.
Chiari malformations are a group of hindbrain abnormalities involving the rhombencephalon and cerebrospinal fluid junction. There are four main types of Chiari malformations described. Chiari type I involves tonsillar herniation below the foramen magnum without brainstem herniation. Chiari type II involves herniation of the brainstem, cerebellar vermis, and fourth ventricle and is associated with myelomeningocele. Chiari type III is an occipital encephalocele with similar anomalies to type II. Chiari type IV involves cerebellar hypoplasia without herniation. Clinical features of Chiari I can include headache, numbness, and
This document provides an overview of various demyelinating diseases of the central nervous system. It begins by defining demyelinating diseases as those involving disruption of myelin, which forms an insulating sheath around axons. It then classifies and describes several specific diseases, including acute disseminated encephalomyelitis (ADEM), inflammatory demyelinating pseudotumor, multiple sclerosis (MS), neuromyelitis optica, central pontine myelinolysis, HIV encephalopathy, progressive multifocal leukoencephalopathy (PML), and others. For each disease, it discusses clinical features, magnetic resonance imaging (MRI) findings, differential diagnoses, and pathology where relevant.
Imaging in inherited metabolic disordersvinothmezoss
Normal myelination of the brain proceeds from central to peripheral, inferior to superior, and posterior to anterior. Metabolic disorders can cause leukodystrophies through dysfunction of lysosomes, peroxisomes, or mitochondria. Lysosomal storage diseases like metachromatic leukodystrophy and Krabbe disease involve accumulation of myelin components due to enzyme deficiencies and appear on imaging as symmetric white matter abnormalities that progress centrifugally.
This document provides an overview of CT and MRI interpretation for various neurological conditions. It begins with examples of MRI sequences showing normal brain anatomy and proceeds to discuss key pathologies including infarction, hemorrhage, infection, tumors, trauma, dementia, multiple sclerosis, epilepsy, and cranial neuropathies. For each condition, representative imaging findings are presented and briefly described to aid in diagnosis and clinical management. The document serves as an educational guide for interpreting neuroimaging studies.
Presentation1.pptx, congenital malformation of the brain.Abdellah Nazeer
More than 2000 congenital brain malformations have been described. Magnetic resonance imaging is useful for studying these conditions. The document provides an overview of important congenital brain malformations, including disorders of organogenesis like Chiari malformations, holoprosencephaly, and cephaloceles. Disorders of histogenesis and cytogenesis such as neurocutaneous syndromes, vascular malformations, and tumors are also discussed. The imaging features of various malformations are presented to aid diagnosis.
Presentation1.pptx sellar and para sellar massesAbdellah Nazeer
The document provides information on imaging techniques and differential diagnosis for sellar and parasellar masses. CT and MRI techniques are described for imaging the sella turcica region with details on slice thickness, field of view, and contrast usage. An anatomic approach is outlined to analyze sellar masses which involves identifying the pituitary gland, lesion location and characteristics, and establishing a differential diagnosis. Common pathologies that can occur in the sella and surrounding structures are then described individually, including the pituitary gland, stalk, optic chiasm, hypothalamus, carotid artery, cavernous sinus, and meninges. Imaging examples of lesions such as pituitary adenomas, craniopharyngiomas, and meningi
Presentation1, radiological imaging of corpus callosum lesios.Abdellah Nazeer
1. The corpus callosum is commonly involved by lesions from various etiologies including congenital abnormalities, demyelination, infection, leukodystrophy, neoplasms, trauma, and vascular causes.
2. Transient lesions of the splenium are often seen in association with epilepsy, antiepileptic drug changes, infections, electrolyte imbalances, and PRES. They typically appear hyperintense on T2/FLAIR and DWI with restricted diffusion resolving within 1 month.
3. Common neoplasms involving the corpus callosum include glioblastoma, which may appear as a "butterfly" lesion crossing the genu, and primary CNS lymphoma presenting with a similar pattern
Structural neuroimaging plays an important role in the assessment and diagnosis of different types of dementia. For Alzheimer's disease, MRI typically shows atrophy of the medial temporal lobes including the hippocampus. Vascular dementia is characterized by multiple brain infarcts visible on CT or MRI. Frontotemporal dementia demonstrates frontal and temporal lobe atrophy that can be asymmetric. Dementia with Lewy bodies may show mild generalized atrophy on MRI with occipital hypometabolism on PET. Scales like the MTA scale are used to quantify hippocampal atrophy, while MRS can detect metabolic changes in dementia. Neuroimaging thus aids in distinguishing dementia subtypes and excluding other pathological conditions.
This document discusses various radiological manifestations of cerebral tuberculosis. It describes that approximately 10% of tuberculosis patients have central nervous system involvement. Imaging plays an important role in the diagnosis and evaluation of various intracranial manifestations of tuberculosis including tuberculous meningitis, tuberculoma, miliary tuberculosis, tuberculous encephalopathy and others. Characteristic radiological findings of each condition are outlined along with recommendations for appropriate imaging modalities. Spinal tuberculosis is also discussed with descriptions of typical radiographic and MRI findings.
1) The document discusses different types of intracranial calcifications including normal variants, vascular, tumors, infections, neurocutaneous syndromes, and basal ganglia calcification.
2) Specific examples are provided for each category such as pineal calcification as a normal variant, atherosclerosis as a vascular cause, meningioma as a tumor, and cysticercosis as an infectious etiology.
3) Causes of basal ganglia calcification discussed include endocrine disorders, metabolic conditions, toxins, and post-therapeutic mineralizing angiopathy following chemotherapy or radiation.
This document summarizes various pediatric white matter diseases seen on imaging. It begins by describing normal myelination patterns in the neonatal brain. It then divides white matter diseases into dysmyelinating, demyelinating, and hypomyelinating categories. Several specific diseases are described in detail, including their characteristic imaging findings. Metachromatic leukodystrophy, Krabbe disease, mucopolysaccharidoses, peroxisomal disorders, adrenoleukodystrophy, Zellweger syndrome, and mitochondrial diseases like MELAS are discussed. Common imaging patterns include abnormal white matter signal, involvement of specific tracts, sparing of U-fibers, and enhancement patterns.
This document provides information on degenerative disorders of the brain, including aging/senile atrophy, dementia, and specific diseases such as Alzheimer's disease. Key points include:
- Normal aging involves ventricular and sulcal dilatation due to cerebral volume loss known as atrophy. Neuronal loss is minimal.
- Dementia has a wide range of pathologies including degenerative diseases like Alzheimer's and vascular causes.
- MRI is useful for assessing regional brain volume loss and signal abnormalities to help diagnose conditions. Specific sequences target features of different diseases.
- Alzheimer's disease is characterized by plaques, tangles, and neuronal loss. It involves atrophy of mesial temporal and temporoparietal regions
This document discusses various toxic and metabolic diseases that can cause abnormalities in the brain. It provides details on liver disease, hypoglycemia, hypoxic ischemic encephalopathy, methanol poisoning, and carbon monoxide poisoning. For each condition, the mechanism and characteristic radiographic findings on techniques such as CT, MRI, T1, T2, FLAIR, and diffusion weighted imaging are described. Bilateral abnormalities are often seen in the basal ganglia, thalamus, and cerebral cortex on imaging for these toxic and metabolic diseases.
Presentation1, radiological imaging of pediatric leukodystrophy.Abdellah Nazeer
This document discusses various pediatric leukodystrophies and white matter disorders that can be evaluated on radiological imaging. It provides descriptions of diseases such as Canavan disease, Alexander disease, Van der Knapp disease, Krabbe disease, GM1 and GM2 gangliosidoses, galactosemia, and Kearns-Sayre syndrome. It discusses the characteristic imaging findings and patterns of involvement for each disease to help with diagnosis. Approaches for evaluating pediatric white matter disorders based on features like macrocephaly, subcortical or deep white matter involvement, and thalamic abnormalities are also outlined.
The document discusses various central nervous system infections, how they can be classified, their routes of entry and imaging appearances. It covers congenital infections including TORCH infections, acquired pyogenic infections such as meningitis, abscesses and ventriculitis. It also discusses viral, parasitic and fungal infections of the CNS. For each type of infection, the causative pathogens, locations, presentations and characteristic imaging findings are outlined.
This document provides an overview of various neuroimaging signs and findings. It describes signs seen on MRI that are characteristic of different neurological conditions. Some examples included are the "eye of tiger appearance" seen in Hallervorden-Spatz disease, the "hot-cross-bun sign" seen in various spinocerebellar ataxias, and the "putaminal slit sign" seen in multiple system atrophy. It also provides images and descriptions of signs seen in conditions like multiple sclerosis, Parkinson's disease, Wilson's disease, tuberculomas, and more. The document serves as a reference for neuroradiologists and neurologists to identify various pathologies based on their imaging appearance.
The document provides information about different MRI sequences and their applications:
- FLAIR sequences suppress the signal from cerebrospinal fluid, highlighting hyperintense lesions near CSF-containing spaces. This makes FLAIR useful for evaluating conditions like multiple sclerosis.
- STIR sequences suppress the signal from fat, making it useful for detecting bone marrow edema which can indicate occult fractures.
- T1-weighted images provide good anatomical details and are best for viewing subacute hemorrhages and fat-containing structures.
Tractography uses diffusion MRI to visually represent nerve tracts in the brain through 3D modeling. It can reveal both long tracts connecting different brain regions and more complex short circuits within the brain. However, nerve tracts are not directly visible through standard imaging techniques. Diffusion MRI measures the directionality of water diffusion within tissues to infer the orientation of fiber tracts. Software then maps the diffusion data to generate color-coded 3D representations of tracts called tractograms. Tractography provides insights into the structure and integrity of white matter pathways in the living brain.
1. The document discusses the anatomy and imaging features of cerebrospinal fluid (CSF) cisterns and spaces. It describes the locations and contents of various cisterns such as the interpeduncular, chiasmatic, crural, ambient and cerebellomedullary cisterns.
2. Imaging findings of different pathological conditions are presented, including benign external hydrocephalus, subdural hematoma, hydrocephalus, atrophy and periventricular leukomalacia. Key distinguishing features between these entities are highlighted.
3. An overview of CSF spaces is given, outlining the appearance of normal, atrophic and edematous/hydrocephalic states.
imaging in neurology - demyelinating diseasesNeurologyKota
This document discusses various demyelinating diseases that can be imaged in neurology. It provides images and descriptions of findings for multiple sclerosis, ADEM, NMO spectrum disorder, Susac syndrome, CLIPPERS, acute disseminated encephalomyelitis, acute hemorrhagic leukoencephalitis, acute necrotizing encephalopathy, and osmotic demyelination syndrome. It compares imaging features of MS and NMOSD that can help differentiate the two conditions. The document also discusses variants of MS like Marburg disease, Schilder disease, and Balo concentric sclerosis.
This document discusses disorders of myelination. It begins by defining myelin and its functions, describing normal myelination milestones. It then covers various white matter disorders including dysmyelination, hypomyelination, and delayed myelination. Specific leukodystrophies are discussed in more detail such as Canavan's disease, Alexander disease, Van der Knapp disease, and glutaric aciduria type 1. Clinical features, imaging findings, and pathology are described for each condition. The document provides an overview of disorders of myelination.
This document discusses imaging in medial temporal lobe epilepsy. It begins by explaining why MRI is important for detecting epileptogenic lesions in refractory cases. It then describes the anatomy of medial temporal lobe structures like the hippocampus and amygdala. The document discusses how hippocampal sclerosis appears on MRI, including features like gliosis, neuronal loss, and atrophy. It also covers other imaging modalities that can help lateralize the seizure focus, such as hippocampal volumetry, relaxometry, MRS, PET, and SPECT. In conclusion, MRI is the best way to diagnose mesial temporal sclerosis by identifying hippocampal hyperintensity and atrophy.
Chiari malformations are a group of hindbrain abnormalities involving the rhombencephalon and cerebrospinal fluid junction. There are four main types of Chiari malformations described. Chiari type I involves tonsillar herniation below the foramen magnum without brainstem herniation. Chiari type II involves herniation of the brainstem, cerebellar vermis, and fourth ventricle and is associated with myelomeningocele. Chiari type III is an occipital encephalocele with similar anomalies to type II. Chiari type IV involves cerebellar hypoplasia without herniation. Clinical features of Chiari I can include headache, numbness, and
This document provides an overview of various demyelinating diseases of the central nervous system. It begins by defining demyelinating diseases as those involving disruption of myelin, which forms an insulating sheath around axons. It then classifies and describes several specific diseases, including acute disseminated encephalomyelitis (ADEM), inflammatory demyelinating pseudotumor, multiple sclerosis (MS), neuromyelitis optica, central pontine myelinolysis, HIV encephalopathy, progressive multifocal leukoencephalopathy (PML), and others. For each disease, it discusses clinical features, magnetic resonance imaging (MRI) findings, differential diagnoses, and pathology where relevant.
Imaging in inherited metabolic disordersvinothmezoss
Normal myelination of the brain proceeds from central to peripheral, inferior to superior, and posterior to anterior. Metabolic disorders can cause leukodystrophies through dysfunction of lysosomes, peroxisomes, or mitochondria. Lysosomal storage diseases like metachromatic leukodystrophy and Krabbe disease involve accumulation of myelin components due to enzyme deficiencies and appear on imaging as symmetric white matter abnormalities that progress centrifugally.
This document provides an overview of CT and MRI interpretation for various neurological conditions. It begins with examples of MRI sequences showing normal brain anatomy and proceeds to discuss key pathologies including infarction, hemorrhage, infection, tumors, trauma, dementia, multiple sclerosis, epilepsy, and cranial neuropathies. For each condition, representative imaging findings are presented and briefly described to aid in diagnosis and clinical management. The document serves as an educational guide for interpreting neuroimaging studies.
Presentation1.pptx, congenital malformation of the brain.Abdellah Nazeer
More than 2000 congenital brain malformations have been described. Magnetic resonance imaging is useful for studying these conditions. The document provides an overview of important congenital brain malformations, including disorders of organogenesis like Chiari malformations, holoprosencephaly, and cephaloceles. Disorders of histogenesis and cytogenesis such as neurocutaneous syndromes, vascular malformations, and tumors are also discussed. The imaging features of various malformations are presented to aid diagnosis.
Presentation1.pptx sellar and para sellar massesAbdellah Nazeer
The document provides information on imaging techniques and differential diagnosis for sellar and parasellar masses. CT and MRI techniques are described for imaging the sella turcica region with details on slice thickness, field of view, and contrast usage. An anatomic approach is outlined to analyze sellar masses which involves identifying the pituitary gland, lesion location and characteristics, and establishing a differential diagnosis. Common pathologies that can occur in the sella and surrounding structures are then described individually, including the pituitary gland, stalk, optic chiasm, hypothalamus, carotid artery, cavernous sinus, and meninges. Imaging examples of lesions such as pituitary adenomas, craniopharyngiomas, and meningi
Presentation1, radiological imaging of corpus callosum lesios.Abdellah Nazeer
1. The corpus callosum is commonly involved by lesions from various etiologies including congenital abnormalities, demyelination, infection, leukodystrophy, neoplasms, trauma, and vascular causes.
2. Transient lesions of the splenium are often seen in association with epilepsy, antiepileptic drug changes, infections, electrolyte imbalances, and PRES. They typically appear hyperintense on T2/FLAIR and DWI with restricted diffusion resolving within 1 month.
3. Common neoplasms involving the corpus callosum include glioblastoma, which may appear as a "butterfly" lesion crossing the genu, and primary CNS lymphoma presenting with a similar pattern
Structural neuroimaging plays an important role in the assessment and diagnosis of different types of dementia. For Alzheimer's disease, MRI typically shows atrophy of the medial temporal lobes including the hippocampus. Vascular dementia is characterized by multiple brain infarcts visible on CT or MRI. Frontotemporal dementia demonstrates frontal and temporal lobe atrophy that can be asymmetric. Dementia with Lewy bodies may show mild generalized atrophy on MRI with occipital hypometabolism on PET. Scales like the MTA scale are used to quantify hippocampal atrophy, while MRS can detect metabolic changes in dementia. Neuroimaging thus aids in distinguishing dementia subtypes and excluding other pathological conditions.
This document discusses various radiological manifestations of cerebral tuberculosis. It describes that approximately 10% of tuberculosis patients have central nervous system involvement. Imaging plays an important role in the diagnosis and evaluation of various intracranial manifestations of tuberculosis including tuberculous meningitis, tuberculoma, miliary tuberculosis, tuberculous encephalopathy and others. Characteristic radiological findings of each condition are outlined along with recommendations for appropriate imaging modalities. Spinal tuberculosis is also discussed with descriptions of typical radiographic and MRI findings.
1) The document discusses different types of intracranial calcifications including normal variants, vascular, tumors, infections, neurocutaneous syndromes, and basal ganglia calcification.
2) Specific examples are provided for each category such as pineal calcification as a normal variant, atherosclerosis as a vascular cause, meningioma as a tumor, and cysticercosis as an infectious etiology.
3) Causes of basal ganglia calcification discussed include endocrine disorders, metabolic conditions, toxins, and post-therapeutic mineralizing angiopathy following chemotherapy or radiation.
This document summarizes various pediatric white matter diseases seen on imaging. It begins by describing normal myelination patterns in the neonatal brain. It then divides white matter diseases into dysmyelinating, demyelinating, and hypomyelinating categories. Several specific diseases are described in detail, including their characteristic imaging findings. Metachromatic leukodystrophy, Krabbe disease, mucopolysaccharidoses, peroxisomal disorders, adrenoleukodystrophy, Zellweger syndrome, and mitochondrial diseases like MELAS are discussed. Common imaging patterns include abnormal white matter signal, involvement of specific tracts, sparing of U-fibers, and enhancement patterns.
This document provides information on degenerative disorders of the brain, including aging/senile atrophy, dementia, and specific diseases such as Alzheimer's disease. Key points include:
- Normal aging involves ventricular and sulcal dilatation due to cerebral volume loss known as atrophy. Neuronal loss is minimal.
- Dementia has a wide range of pathologies including degenerative diseases like Alzheimer's and vascular causes.
- MRI is useful for assessing regional brain volume loss and signal abnormalities to help diagnose conditions. Specific sequences target features of different diseases.
- Alzheimer's disease is characterized by plaques, tangles, and neuronal loss. It involves atrophy of mesial temporal and temporoparietal regions
This document discusses several inherited white matter diseases:
1. Metachromatic leukodystrophy is caused by a deficiency of the enzyme arylsulfatase A, leading to accumulation of sulfatides. MRI shows symmetric T2 hyperintensities in the periventricular and cerebellar white matter.
2. Krabbe disease is caused by a deficiency of galactocerebrosidase, leading to accumulation of galactocerebrosides. Characteristic MRI findings include T2 hyperintensities along the corticospinal tracts.
3. Mucopolysaccharidoses result from deficiencies of lysosomal enzymes involved in glycosaminoglycan breakdown, leading to their accumulation. MRI
This case involves a 2-year-old male child who presented with fever and seizures and was found to have meningeal irritation on examination. MRI showed bilateral symmetrical hyperintensities involving the cortical grey matter of the frontal, parietal, occipital and temporal lobes, as well as the insula and sylvian fissure, with restricted diffusion. There was also hyperintensity in the thalami and caudate heads without restriction. CSF analysis revealed lymphocytic pleocytosis. These findings are consistent with viral encephalitis.
radiology ppt on mri sequences how to read basic mri sequences and basic path...drashish05
MRI of the brain showed abnormalities in a patient with dengue encephalitis including:
1. Hyperintensities in the bilateral basal ganglia on T1 and T2 FLAIR images.
2. Diffuse areas of diffusion restriction in both cerebral hemispheres, basal ganglia, and caudate nuclei, sparing the thalami and frontal white matter.
3. Increased cortical hyperintensities over time in the parieto-occipital lobes and thalami.
4. Diffusion restriction and hyperintensities in the pons, thalami, and hippocampi.
LEUKODYSTROPHY FINAL.pptx sms medical jaipurdineshdandia
1) The document discusses various white matter disorders including dysmyelination, demyelination, and hypomyelination.
2) Key points about various leukodystrophies are provided including their genetic causes, typical MRI findings, and clinical presentations.
3) A step-by-step approach to the diagnostic evaluation of adult leukodystrophies based on imaging patterns is described. Common leukodystrophies like X-linked adrenoleukodystrophy, metachromatic leukodystrophy, and Alexander disease are discussed in detail.
approachtomuscleweakness modified- By Sir Ghani.pptxZOHAIB57
1) The document discusses differentiating between true muscle weakness and fatigue, and provides an algorithmic approach to evaluating the cause of weakness.
2) Key points include differentiating acute vs. chronic onset, unilateral vs. bilateral involvement, and determining if signs are upper or lower motor neuron.
3) Common causes discussed include stroke, spinal cord lesions, peripheral neuropathies, myasthenia gravis, and myopathies. The algorithm provides guidance on determining the localization and cause based on history and exam findings.
In this presentation we will discuss the role of MRI in the diagnosis of this rare Prion disease.
DWI is of diagnostic value in the diagnosis of Creutzfeldt Jakob Syndrome.
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system or bilateral damage to the thalamus or both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering glucose/thiamine/naloxone/flumazenil as needed. A thorough neurological exam assesses level of consciousness, brainstem reflexes, motor function, and helps differentiate structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
This document provides information about coma, including its neuroanatomical basis, causes, definitions of related states, assessment, and differential diagnosis. Coma results from dysfunction of the brainstem reticular activating system, thalamus, or diffuse lesions in both cerebral hemispheres. Immediate management of coma involves assessing ABCs and administering supportive medications. A thorough neurological exam evaluates level of consciousness, brainstem reflexes, motor function, and more to localize lesions and distinguish structural from toxic/metabolic causes. Pseudocoma conditions like locked-in syndrome or catatonia can mimic true coma and require different management.
The document discusses the goals and techniques used in the presurgical evaluation of patients with epilepsy. The main goals are to accurately map the brain region responsible for generating seizures (epileptogenic zone) while avoiding functional areas. Key techniques discussed include high-resolution MRI to identify lesions, scalp EEG monitoring to localize seizures, fMRI to map language and motor functions, and MRS to identify metabolic abnormalities. A multidisciplinary team evaluates all test results to localize the seizure focus and plan the safest surgery.
This document provides an overview of autoimmune encephalitis (AE) and discusses a case study. It begins with introducing the case of a 68-year-old female presenting with behavioral changes and seizures. Diagnostic workup showed abnormal EEG and MRI findings. Serum testing was positive for LGI1 antibodies, leading to a diagnosis of anti-LGI1 antibody encephalitis. The document then reviews AE in general, discussing pathogenesis, clinical presentation, diagnostic criteria and workup, management, and prognosis for different antibody types like anti-NMDA receptor and VGKC encephalitis. It emphasizes the importance of early recognition and treatment for potential recovery from AE.
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This case report describes a 13-year-old boy who presented with headache, vomiting, and fever and was diagnosed with meningitis. After two days, he developed seizures and impaired consciousness. MRI showed lesions in multiple areas of the brain. A follow up MRI months later showed the lesions had completely resolved. He was diagnosed with reversible posterior leukoencephalopathy syndrome (RPLS), likely caused by severe hypertension. RPLS is characterized by reversible brain lesions and is associated with conditions that cause abrupt changes in blood pressure. The patient's symptoms improved with blood pressure control and he made a full recovery.
1. The document discusses various white matter disorders that can be seen on MRI imaging. It focuses on demyelinating diseases like multiple sclerosis (MS), neuromyelitis optica (NMO), acute disseminated encephalomyelitis (ADEM), and other related conditions.
2. MS is characterized by well-defined white matter lesions that are often ovoid or perpendicular to the ventricles. Lesions can also be seen in the corpus callosum, brainstem, spinal cord, and optic nerves. MRI is important for diagnosis and monitoring of MS.
3. NMO preferentially affects the spinal cord and optic nerves. Lesions are often longitudinally extensive in the spinal
chiari or arnold chiari malformations, various types and pathophysiology, radiological and clinical presentation of the types, signs symptoms, investigations and treatment of these malformations both conservative and surgical. considerations and controversiies in management of chiari malformation associated with various conditions.
This document discusses the approach to patients presenting in a coma. It defines coma as a state of unresponsiveness where patients cannot be aroused even with vigorous stimulation. It describes various stages between alertness and coma. Coma is caused by dysfunction of the brainstem or both hemispheres of the brain. A thorough assessment is needed to determine the cause and guide management, including a neurological exam to identify any focal signs. Key aspects of the exam include vital signs, pupil response, eye movements, motor response and reflexes. Different patterns on exam can localize the lesion causing the coma. Immediate life-saving interventions are also often needed.
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This document discusses the role of MRI in evaluating brain haemorrhages and traumatic brain injuries. It describes the appearance of blood on MRI over time from acute to chronic stages. It also covers imaging findings and characteristics of different types of intracranial haemorrhages including intraaxial, extraaxial, epidural and subdural haemorrhages. Mass effect from haemorrhages can cause brain herniations which are also discussed.
1. The document discusses toxic encephalopathy and provides details on various toxic disorders that can cause it.
2. It describes how alcohol and related toxins like methanol can cause acute or chronic brain changes including diffuse swelling, lesions in the basal ganglia and white matter abnormalities.
3. A rare but serious alcohol-related condition discussed is Marchiafava-Bignami disease which involves demyelination and necrosis of the corpus callosum.
Similar to D/D BIATERAL BASAL GANGLIA HYPERINTENSITIES (20)
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1) The document discusses signs that can help localize lesions causing coma, including abnormalities in respiratory patterns, pupil size and response, eye movements, and corneal and limb reflexes.
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Dr. Bharat Bhushan is a professor of medicine and interventional neurologist at Government Medical College in Kota, Rajasthan, India. He has over 18 years of experience and qualifications including MBBS, MD, DM in Neurology, and FICP. He has published over 35 research papers and contributed to several medical research projects. The document discusses the concept of a "treadmill for the brain" to improve cognitive fitness through a balanced routine of exercise, sleep, and diet in order to stimulate and exercise the brain. It emphasizes coordinating the adaptation of organs like the gut, muscles and brain for overall health and quality of life.
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The document discusses autonomic function tests which are used to evaluate autonomic nervous system disorders. It describes various cardiovascular, sudomotor and pupillary reflex tests to assess different aspects of autonomic function. Cardiovascular tests include postural challenge tests, Valsalva maneuver, deep breathing test and isometric handgrip test. Sudomotor tests include quantitative sudomotor axon reflex test and thermoregulatory sweat test. The tests help diagnose autonomic dysfunction, evaluate its severity and distribution. Management involves identifying and treating the underlying cause, along with medications and lifestyle changes to alleviate symptoms like orthostatic hypotension.
Transcranial Doppler (TCD) ultrasonography is a noninvasive technique used to evaluate cerebral blood flow velocities. It was originally introduced in 1982 to detect vasospasm in subarachnoid hemorrhage. TCD is now used for a variety of purposes including detection of stenosis, occlusion, emboli, shunts, and vasospasm. It provides diagnostic information for conditions such as stroke, sickle cell disease, brain death, and arteriovenous malformations. TCD utilizes Doppler effect to measure blood flow velocities in basal cerebral arteries which provides data to assess hemodynamics and diagnose various cerebrovascular diseases.
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1) The document discusses intracerebral hemorrhage (ICH) in young adults aged 18-50 years.
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A 42-year-old male patient was admitted with repeated dizziness and right-sided weakness for over 3 months. Imaging showed a linear filling defect in the proximal left internal carotid artery, revealing over 90% stenosis and delayed blood flow. The patient underwent carotid endarterectomy and was discharged on medical therapy. Three months later, the patient experienced recurrent symptoms. Carotid web was considered a potential cause given the patient's age and lack of atherosclerosis history. Intervention may be a safe and effective option for symptomatic carotid web in addition to medical management, with recurrent risk up to 26.8% with medical management alone.
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Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
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D/D BIATERAL BASAL GANGLIA HYPERINTENSITIES
1. BILATERAL BASAL GANGLIA HYPERINTENSITIES –
IMAGING IN AUTOIMMUNE ENCEPHALITIS
DR. PIYUSH OJHA
DM RESIDENT
DEPARTMENT OF NEUROLOGY
GOVT MEDICAL COLLEGE, KOTA
2.
3. • Mesial temporal hyperintensities, either unilateral or bilateral with or
without enhancement after gadolinium administration, are classic
autoimmune limbic encephalitis findings.
• The lateral temporal lobe and insula less commonly involved
• Basal ganglia, in contrast, are frequently involved - distinguish it
from HSV encephalitis which characteristically spares the basal
ganglia
• Normal imaging is common, particularly in the early illness stages
• Extratemporal abnormalities sometimes observed.
• If lesions are not in a typical distribution or have avid enhancement,
other inflammatory (eg. neurosarcoidosis) or oncologic (eg.
lymphoma) diagnoses should be considered.
4.
5. FUNCTIONAL IMAGING :
• Global hypometabolism is the most common feature encountered
in patients with autoimmune encephalopathies.
• However, focal hypometabolism can also be encountered.
• In instances where the patient has seizures, hypermetabolism can
occur.
6.
7.
8. Anti-glutamic acid decarboxylase encephalitis. A 61-year-old woman presented with headaches, mild confusion, and
nystagmus without development of psychosis, severe encephalopathy, or seizures. MR imaging of the brain demonstrates
T2-FLAIR hyperintensity in the right >left hippocampus (A and B), right > left insular cortex (B), and bilateral cingulate gyrus
(C and D) without restricted diffusion (not shown), hemorrhage (not shown), or postcontrast enhancement
(not shown).
9. Anti-N-methyl D-aspartate receptor encephalitis. A 32-year-old woman presented with headaches, vertigo, and
psychosis with subsequent development of encephalopathy and seizures. MR imaging of the brain performed
after the onset of seizures 2 weeks after initial presentation demonstrates T2-FLAIR hyperintensity in the left
inferior temporal lobe (A), left > right insular cortex (B and C), and left > right cingulate gyrus (B–D), without
restricted diffusion (not shown), hemorrhage (not shown), or postcontrast enhancement (not shown).
10. DIFFERENTIAL DIAGNOSIS of
Bilateral Basal Ganglia Hyperintensities in an adult
• Hypoxic-Ischemic Injury – Near drowning, cardiac arrest,
• Viral Encephlitis – West Nile, HSV, Japanese Encephalitis
• Osmotic Demyelination Syndrome
• Toxin exposure – CO poisoning - Globus pallidus involvement
• Wilson disease
• CJD
• CVT
• Metabolic – Hepatic Encephalopathy
11. Carbon monoxide poisoning in a 33-year-old man who was found in a coma after a suicide attempt. Axial T2-
weighted (a) and coronal fluid-attenuated inversion recovery (b) MR images obtained 4 weeks after the poisoning
depict symmetric hyperintense foci in the globus pallidus (arrows). Symmetric hyperintense areas in the deep white
matter (arrowheads in b) are consistent with delayed leukoencephalopathy.
12. Acute hyperammonemia in a 70-year-old cirrhotic man with acute decompensated hepatic failure who presented with
altered mental status. T2-weighted (a) and diffusion-weighted (b) MR images reveal bilaterally symmetric swelling,
hyperintensity, and restricted diffusion in the caudate heads (white arrows in a), putamina (black arrows in a), and
insular cortices (arrowheads in b).
13. Hypoglycemic brain injury in an 18-year-old comatose man with a random blood sugar level of 2.1 mmol/L. Axial
T2-weighted (a) and diffusion-weighted (b) MR images demonstrate diffuse hyperintensity and restricted diffusion in
the heads of the caudate nuclei (arrowheads in a), lentiform nuclei (arrows in a), and cerebral cortex, with sparing of
the subcortical white matter and thalamus.
14. HIE in a 38-year-old woman who was resuscitated after being involved in a traffic accident. (a) T2-
weighted MR image demonstrates bilaterally symmetric hyperintense areas in the thalamus (white
arrowheads), basal ganglia, and cerebral cortex. Black arrow-heads = caudate nuclei, arrows = lentiform
nuclei. (b) T2-weighted MR image obtained at a higher level more clearly depicts diffuse cortical
involvement.
15. Wilson disease in a 9-year-old boy with tremors and dystonia. T2-weighted MR image depicts bilaterally
symmetric areas of abnormal T2 prolongation in the ventrolateral thalamus (arrowheads), putamina (white ar-
rows), and caudate nuclei (black arrows).
16. Osmotic myelinolysis in a 59-year-old alcoholic man who presented with confusion and pseudobulbar palsy. (a)
T2-weighted MR image depicts bilaterally symmetric hyperintense areas in the thalamus (arrowheads) and
putamina (arrows). (b) T2-weighted MR image obtained inferior to a demonstrates an ill-defined hyperintense area
in the central pons (*), with sparing of the rim.
17. Wernicke encephalopathy in a 36-year-old alcoholic man with impaired consciousness.
(a) Axial T2-weighted MR image shows bilaterally symmetric areas of T2 prolongation in the paramedian thalamus
along the third ventricle (white arrowheads), the caudate nuclei (black arrow-heads), and the putamina (arrows). (b)
Axial T2-weighted MR image shows ill-defined hyperintense areas in the periaqueductal region (arrow).
18. Deep CVT in a 37-year-old woman with headache and drowsiness. (a) T2-weighted MR image shows bilateral
hyperintense areas in the thalamus (arrowheads) and caudate heads (arrows). (b) Phase-contrast MR venogram
shows absence of normal flow in the internal cerebral veins, vein of Galen, and straight sinus (arrows), with
preservation of the superior sagittal and transverse sinuses.
19. Seropositive Japanese B encephalitis in a 14-year-old boy with fever and malaise.
T2-weighted (a) and diffusion-weighted (b) MR images reveal asymmetric ill-defined hyperintense
areas in the thalamus (arrows in a) and the left frontal and parieto-occipital cortex (arrowheads in a).