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107 Cards in this Set

  • Front
  • Back
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, HTN encephalopathy (eclampsia, cyclosporine)
saccular – degenerative, trauma, mycotic, vasculopathies; fusiform – atherosclerotic; dissecting – trauma > vasculopathy > spontaneous
aneurysm (#1), trauma, AVM, coagulopathy, extension of intraparenchymal bleed, idiopathic, spinal AVM
Vascular malformations
AVM, capillary telangiectasia, cavernous malformation, venous anomaly, vein of Galen AVM or varix
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 dissection (spontaneous, trauma, HTN, vasculopathy, migraine, IVDA), CCF
Extraaxial masses
hemisphere – meningioma, mets, lymphoma, arachnoid cyst, dermoid/epidermoid, hemorrhagic or infectious fluid collections, hemangiopericytoma; clivus/prepontine cistern – meningioma, mets, chordoma, chondrosarcoma; CPA mass – acoustic neuroma, meningioma, mets, epidermoid, petrous apex cholesterol granuloma, paraganglioma, aneurysm, arachnoid cyst
Intraaxial masses
hemisphere – astrocytoma, GBM, oligodendroglioma, lymphoma, mets, PNET, ganglioglioma, DNET; sella – adenoma, craniopharyngioma, Rathke’s cyst, mets, abscess, sarcoid, EG stalk; brainstem – astrocytoma, GBM; pineal region – germinoma, teratoma, pineocytoma, pineoblastoma; cerebellum – astrocytoma, medulloblastoma, hemangioblastoma, mets, ependymoma, choroid plexus papilloma; temporal lobe in young patient – ganglioglioma, DNET, JPA, PXA
Multiple lesions
tumor – mets, GBM, lymphoma; infection – abscess, fungus, cysticercosis, toxoplasmosis; vascular – embolic infarctions, multifocal hemorrhage, DAI, contusions, cavernous hemangiomas, vasculitis
Corpus callosum lesions
tumors – GBM, lymphoma, lipoma, mets (rare); demyelinating – MS, ADEM, PML; infarct – always also involves cingulate gyrus; trauma - DAI
Intrasellar masses
pituitary adenoma, apoplexy, craniopharyngioma, Rathke’s cyst, mets, aneurysm, abscess
Suprasellar masses
SATCHMOE – sellar lesion extending superiorly, sarcoid, aneurysm, arachnoid cyst, teratoma, craniopharyngioma, hypothalamic glioma, mets, meningioma, optic nerve glioma, EG, epidermoid/dermoid; adults – macroadenoma (#1), meningioma, glioma, craniopharyngioma, aneurysm; children – craniopharyngioma (#1), glioma, germinoma, hypothalamic hamartoma, EG
Posterior fossa tumors
adults – mets, hemangioblastoma, astrocytoma, choroid plexus papilloma, meningioma, epidermoid, dysplastic gangliocytoma; 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; children – choroid plexus papilloma, ependymoma, medulloblastoma, teratoma, astrocytoma; lateral ventricle – PNET, choroid plexus papilloma, glioma, JPA, subependymoma, astrocytoma, mets, oligodendroglioma, meningioma, central neurocytoma; 3rd ventricle – astrocytoma, EG stalk, germinoma, extrinsic craniopharyngioma, colloid cyst, glioma, mets, pituitary or pineal mass, aneurysm, sarcoid; 4th ventricle – ependymoma, medulloblastoma, choroid plexus papilloma, mets, hemangioblastoma, subependymoma
CPA mass
acoustic neuroma (#1), meningioma, epidermoid, arachnoid cyst, mets, ependymoma through Luschka, lipoma
Cystic mass
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
intraaxial – lung, breast, colon, melanoma; extraaxial – breast, lymphoma, prostate, neuroblastoma; hemorrhagic – melanoma, renal, chorioCA, thyroid
Tumors with CSF seeding
choroid plexus papilloma, ependymoma, PNET (medulloblastoma), piineoblastoma, germinoma, GBM
Hyperdense lesion on CT
lymphoma, medulloblastoma/PNET, ependymoma, germinoma, GBM, hemorrhagic mets, mucinous mets, osteogenic tumor, hemorrhage, meningioma, colloid cyst, aneurysm
Calcified intraparenchymal lesions
oligodendroglioma, ependymoma, mucinous adenoCA, osteogenic sarcoma, toxoplasmosis, 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, lymphoma, myeloma, neuroblastoma, fibrous tissue (meningioma), high protein concentration, flow void
T1 hyperintense lesions
Gd, methemoglobin, melanin, certain states of calcium, fat (dermoid), high protein concentration (colloid cyst), slow flow
Lesions with no enhancement
cysts, tumors with intact BBB (low-grade gliomas)
Lesions with strong enhancement
meningioma, medulloblastoma/PNET, AVM, paraganglioma, aneurysm, HIV-associated lymphoma, GBM
Ring enhancement
mets, abscess, GBM, infarct, contusion, AIDS, lymphoma, demyelinating, resolving hematoma, radiation
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 chronic degenerative disease (MS, Parkinson’s), childhood hypoxia
T2 hyperintense basal ganglia lesions
tumor – lymphoma, NF; ischemia – hypoxic encephalopathy, venous infarction; neurodegenerative diseases (uncommon), Leigh’s dz; toxin – CO, CN, H2S poisoning, hypoglycemia, methanol; infection – Cryptococcus, parasites
T1 hyperintense basal ganglia lesions
dystrophic calcifications (any cause), hepatic failure, NF, manganese
Basal ganglia calcification
physiologic (#1), hypoparathyroid, HPT, TORCH, AIDS, TB, toxoplasmosis, cysticercosis (common), lead, CO, radiation, chemotherapy, Fahr’s disease, mitochondrial (common), ischemic-hypoxic injury
White matter disease
demyelinating (MS, ADEM, CPM), dysmyelinating (leukodystrophies), tumor (lymphoma, mets) vasculopathies (small vessel ischemic dz, vasculitis, HTN, eclampsia, migraines, radiation, chemotherapy, cyclosporine, IVDA), inflammatory (Lyme, sarcoid, HIV, PML, CMV)
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 ventricle tumors, colloid cyst, oligodendroglioma, central neurocytoma, giant cell astrocytoma in TS, ependymoma, suprasellar tumors; aqueduct obstruction – congenital aqueductal stenosis, ventriculitis, IVH, tumor (mesencephalic, pineal, posterior 3rd ventricle region); 4th ventricle obstruction – DW malformation, IVH, infection, subependymoma, exophytic brainstem glioma, posterior fossa tumors
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 hypoplasia/aplasia and large posterior fossa), DW variant (normal size posterior fossa and vermian hypoplasia), megacisterna magna (normal vermis), retrocerebellar arachnoid cyst (must show mass effect), Chiari 4 (near complete absence of cerebellum), epidermoid/dermoid, cystic tumor, Joubert’s syndrome (superior vermian hypoplasia/aplasia), rhomboencephalosynapsis (vermian hypoplasia/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
NF, TS, VHL, Sturge-Weber
Diffuse marrow involvement
mets, myeloma, lymphoma, leukemia, anemia, Paget’s, FD
Spinal cord compression
criteria – no CSF seen around cord, narrowed AP diameter of cord (<7mm), deformity of cord; causes – infection (TB, pyogenic), compression fracture (CA, trauma), spondylosis and disk disease (herniated nucleus, hypertrophy of ligaments, osteophyte, facet hypertrophy), primary bone disorders (Paget’s), epidural hematoma
Intramedullary lesions
astrocytoma (#1), ependymoma (#2), hemangioblastoma, lymphoma, mets (rare), demyelinating disease/myelitis, syrinx, AVM, trauma (contusion), radiation, sarcoid, infection (rare), infarction
Intradural extramedullary lesions
nerve sheath tumor (#1), meningioma, drop mets, lipoma, teratomatous lesion, arachnoid cyst, arachnoiditis/meningitis, AVM/AVF, ependymoma, sequestered disc fragment, lymphoma, sarcoid, pantopaque
Extradural lesions
disc disease, mets, lymphoma, epidural abscess, epidural hematoma, lipomatosis (thoracic), synovial cyst, extramedullary hematopoiesis, Tarlov cyst, discitis/osteomyelitis, spondylolysis, RA
primary – Chiari malformations, spinal dysraphism, DW, 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 fracture); 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
tumors – hemangioma (adults
Extraconal disease
nasal disease – infection, neoplasm; orbital bone disease – subperiosteal abscess, osteomyelitis, FD, tumors, trauma; sinus disease – mucocele, invasive infections, neoplasm; lacrimal gland disease – 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 (with enlarged superior ophthalmic vein) – 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
abnormal T2 signal and enhancement and nerve enlarged – glioma, meningioma
Optic nerve sheath enlargement
tumor – optic nerve glioma, meningioma, meningeal carcinomatosis, mets, lymphoma, leukemia; inflammatory – optic neuritis, pseudotumor, sarcoid; increased intracranial pressure; 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 adjacent sinus, TB, sarcoid, carotid cavernous fistula, hemorrhage, tumor
Childhood orbital masses
retinoblastoma, rhabdomyosarcoma, optic nerve glioma, lymphoma, leukemia, hemangioma, lymphangioma, dermoid, 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 (calcification in endstage disease, shrunken bulb), optic nerve drusen (most common cause of calcifications in adults, bilateral)
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
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
sarcoid, Sjogren’s, HPT
Cystic extrathyroid lesions
neck – branchial cleft cyst (lat to carotid), thyroglossal duct cyst (midline mass), ranula (retention cyst of sublingual glands), retention cysts of mucous glands (parotid), cystic hygroma (lymphangioma, most common < 2y/o); nasooropharnyx – Thornwald’s cyst, mucus retention cyst, necrotic SCC; larynx, paralaryngeal space – 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 tumor – carotid body, vagale, jugulare, tympanicum; hemangioma; AVM; aneurysm (often ICA) – pseudoaneurysm, posttraumatic
Vocal cord paralysis
tumor, post-op, iatrogenic, idiopathic
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
cysts, ameloblastoma, odontogenic carcinoma or sarcoma; nonodontogenic – osteosarcoma, chondrosarcoma, Ewing’s, myeloma
Chiari I
Low tonsils.
Small fourth ventricle.
Klippel feil.
Occipitalization of the atlas.
Chiari II
Low tentorium.
Medullary kink.
Beaked tectum.
Corpus callosum agenesis.
Lacunar skull.
Chiari III
Cervical occipital encephalocele that contains cerebellum.
Chiari IV
Severe cerebellar hypoplasia.
Failure to separate into hemispheres. Alobar: complete failure, no falx, single mono-ventricle, fused thalami. Semi lobar: Partial separation of the posterior occipital and temporal lobes. Frontal brain is fused, thalami partially fused. Ace of spades configuration of the ventricles. Lobar: fusion of only anterior inferior frontal lobes so no faux in that location. Otherwise the brain appears to be quite normal except for lack of septum pellucidum. Septal optic dysplasia: most mild form in which there is no septum pellucidum and the optic nerves are very atrophic. Schizencephaly may be present in fifty percent of these cases. Corpus callosum agenesis may also be seen with this entity.