Neuro Ddx

Front 1

Increased Signal on T1

Back 1

Fat
High Protein
Subacute Hemorrhage (Methemoglobin)
Gadolinium
Other Paramagnetics (Manganese, Calcium, Melanin)

Front 2

Decreased Signal on T1

Back 2

Water (CSF, Edema)
Acute Hemorrhage (Deoxyhemoglobin)
Chronic Hemorrhage (Hemosiderin)
Diamagnetic Effects (Calcification, Air)
Fast Blood Flow
Very Viscous Protein

Front 3

Increased signal on T2

Back 3

Water (CSF, Edema)
Late Subacute Hemorrhage (Extracellular Methemoglobin)

Front 4

Decreased signal on T2

Back 4

Fat (NON-FSE)
High Protein
Acute Hemorrhage (Deoxyhemoglobin)
Chronic Hemorrhage (Hemosiderin)
Early Subacute Hemorrhage (Intracellular Methemoglobin)
Other Paramagnetics (Melanin, Calcium)
Diamagnetic Effects (Calcification, Air)
Fast Blood Flow

Front 5

MR signal of hemorrhage

Back 5

“ITY BITY BABY DODO”
Deoxy Hemoglobin ID (Iso T1, Dark T2)
Intracellular Methemoglobin BD (Bright T1, Dark T2)
Extrecellular Methemoglobin BB (Bright T1, Bright T2)
Hemosiderin DD (Dark T1, Dark T2)

Front 6

Causes of intracerebral hemorrhage

Back 6

Trauma (Inc. edema)
Infarction (Inc. edema)
Primary Neoplasm/Mets (Inc. edema)
Hypertension (basal ganglia, cerebellum, brainstem)
Amyloid Angiopathy (elderly)
Aneurysm
AVM
Vasculitis
Dural Sinus Thrombosis
Bleeding Diatheses
Cavernous Hemangioma

Front 7

Which are the hemorrhagic mets?

Back 7

1. RCC
2. Thyroid
3. Choriocarcinoma
4. Melanoma
5. Lung
6. Breast

Front 8

Cerebellar pontine angle masses

Back 8

Vestibular Schwannoma (8)
Meningioma
Epidermoid
Nonacoustic Schwannoma (5, 7)
Mets
Arachnoid Cyst
Aneurysm

Front 9

Sellar/ Para-sellar masses

Back 9

Pituitary Adenoma
Rathke Cleft Cyst
Craniopharyngioma
Aneurysm
Meningioma
Optic Glioma
Hypothalmic Glioma
Hypothalmic Hamartoma
Sarcoid
TB
Germ Cell Tumor

Front 10

Pituitary stalk enhancing masses

Back 10

Sarcoidosis
EG
Lymphoma
Mets
Glioma
Germinoma

Front 11

Pineal region masses

Back 11

Germ Cell Tumor (Teratoma or Seminoma)
Pineoblastoma
Pineocytoma
Cyst
Glioma
Lipoma
Vein of Galen Malformation
Trilateral Retinoblastoma

Front 12

Clivus masses

Back 12

Chordoma
Mets
Plasmacytoma
Chondrosarcoma

Front 13

Posterior Fossa Lesion (Adult)

Back 13

Infarction (Most common cause of Non-Communicating Hydrocephalus.
Other causes include Aqueductal Stenosis, Brainstem Glioma)
Mets
Hemangioblastoma
MS
Abscess

Front 14

CNS Tumors that Subarachnoid Seed

Back 14

Medulloblastoma
Glioblastoma Multiforme
Ependymoblastoma
Pineoblastoma
Oligodendroglioma
CPP
Germinoma

Front 15

Widened Skull Dipole

Back 15

Paget Disease (“cotton wool”)
Fibrous Dysplasia
Sickle Cell/Thalassemia (“hair-on-end”)
Locally with Meningioma

Front 16

Posterior Fossa Mass (Child)

Back 16

Medulloblastoma (Displaced 4th Ventricle Anteriorly, Drop Mets)
Pilocytic Astrocytoma
Ependymoma (Displaces 4th Ventricle Posteriorly, “Plastic” Tumor)
Brainstem Glioma

Front 17

Posterior Fossa “Cyst”

Back 17

Epidermoid Cyst
Arachnoid Cyst
Dandy Walker Cyst (and Dandy Walker Variant)
Mega Cisterna Magna

Front 18

Childhood Brain Tumors

Back 18

Pleomorphic Xanthoastrocytoma (Teenager, Temporal Lobe, Cystic with a Mural Nodule)
Ganglioglioma (Benign)
Dysembryoplastic Neuroepithelial Tumor
Primitive Neuroectodermal Tumor (Aggressive, Intense Enhancement, Dense Cell Packing)
Oligodendroglioma (Chunky Calcifications, Frontal Lobes)
Ependymoma

Front 19

Lesions Associated with Agenesis of Corpus Callosum

Back 19

(Parallel Lateral Ventricles, “High-Riding” 3rd Ventricle, Colpocephaly)
Isolated Dandy-Walker Syndrome
Septo-Optic Dysplasia (NO Septum Pellucidum)
Holoprosencephaly (NO Septum Pellucidum)
Chiari II
Schizencephaly (May Not Have Septum Pellucidum)
Lipoma
Encephaloceles

Front 20

Expanded Spinal Cord

Back 20

Ependymoma (SAH, Syrinx)
Astrocytoma (Syrinx)
Hemangioblastoma (Syrinx)
MS
Transverse Myelitis
Infection
AVM
Syrinx
Cavernous Hemangioma
Radiation
Hemorrhage

Front 21

Extramedullary/ Intradural Spinal Cord Mass

Back 21

Schwannoma/Neurofibroma (CAUDA EQUINA)
Meningioma
Myxopapillary Ependymoma (CAUDA EQUINA)
Drop Mets (Medulloblastoma, Glioma)
Mets (Breast, Lung)
Non-Hodgkin Lymphoma
Dural AVM
Hematoma

Front 22

Extradural Spinal Mass

Back 22

Herniated Disk
Synovial Cyst
Lymphoma
Veretebral Body (Osteophyte, Hemangioma, Metastases, Other Tumors)
Epidural Abscess
Epidural Hematoma
Epidural Lipomatosis

Front 23

Causes of Syrinx

Back 23

Tumor (see above)
Chiari I
Trauma

Front 24

Cerebral Ischemia by Age - PEDS

Back 24

PEDS
Meningitis
Trauma
Congenital Heart Dz

Front 25

Cerebral Ischemia by Age - Young adult

Back 25

YOUNG ADULT
Dissection
Drugs (methamphetamine, heroine)
Cardiac Emboli
Venous Thrombosis (OCP’s)

Front 26

Cerebral Ischemia by Age - Elderly

Back 26

ELDERLY
Amyloid
Coagulopathy
Atherosclerosis

Front 27

Ring Enhancing Lesion in the Brain

Back 27

Metastases
MS (Active Demyelination)
Abscess
Glioblastoma
Infarct
Resolving Hematoma
Radiation Necrosis
AIDS- Lymphoma and Toxoplasmosis

Front 28

Calcified Mass

Back 28

Oligodendroglioma
Meningioma
Radiation Treated Tumor
Cavernous Angioma
Calcifiactions Without Mass (Cystercercosis, Mineralizing Angiopathy from Radiaiton, TORCH in Neonate)

Front 29

Hyperdense/Non-calcified Mass on NCECT

Back 29

Lymphoma
Meningioma
Medulloblastoma
Rathke’s Cleft Cyst
Hemorrhage (See causes of Hemorrhage on the First Page)
Germinoma
Colloid Cyst
Iron-Containing Lesion (Old Hemorrhage)

Front 30

Lesions Crossing the Corpus Callosum

Back 30

Lymphoma
Glioblastoma Multiforme
MS

Front 31

Third Ventricular Mass

Back 31

Colloid Cyst
Craniopharyngioma
Hypothalmic/Thalamic Glioma
Basilar Tip Aneurysm
Mets

Front 32

Intraventricular Mass

Back 32

Meningioma (Atria of Lateral Ventricle)
Choroid Plexus Papilloma (Atria of Lateral Ventricle in Children, 4th Ventricle in Adults)
Subependymal Giant Cell Astrocytoma (Arises Foramen of Munroe)
Central Neurocytoma (Attached to Septum Pellucidum)
Ependymoma
Medulloblastoma
Cysticercosis
Mets

Front 33

Leptomeningeal Enhancement

Back 33

Meningitis (Viral or Bacterial)
Carcinomatosis
TB (Basilar Meninges)
Cocci (Basilar Meninges)
Neurosarcoidosis (Basilar Meninges)
Sturge Weber (Associated with Cortical Atrophy and Enlarged Ipsilateral Choroid Plexus)

Front 34

White Matter Disease in the Brain

Back 34

A) DEMYELINATING
MS
Acute Disseminated
Encephalomyelitis
Lyme Dz
Posterior Reversible
Encephalopathy (eclampsia, cyclosporin)
PML
AIDS
B) DYSMYELINATING
Adrenolekodystrophies (Posterior)
Alexender’s (Anterior)
Canavan’s
C) ISCHEMIA
Microangiopathic Ischemic Dz
Vasculitis
Radiation
D) TOXIC
ETOH
E) TRAUMATIC
Sheer

Front 35

Increased T1WI Basal Ganglia

Back 35

Dystrophic Calcifications
Hepatic Failure (Increased ammonia)
TPN (manganese)
NF1

Front 36

Increased T2WI Basal Ganglia

Back 36

Carbon Monoxide (GP-medial)
ADEM
Ischemia
Wilson’s Dz
Leigh’s Dz

Front 37

Decreased T2WI Basal Ganglia

Back 37

Iron Deposition (Hemochromatosis)
Hallervorden-Spatz Dz

Front 38

Increased T2 Signal in the Brainstem

Back 38

Glioma
ADEM
Central Pontine Myelinolysis (Spares Corticospinal Tracts)

Front 39

Increased T2 Signal in the Temporal Lobe(s)

Back 39

Herpes Encephalitis
Low Grade Tumor
Infarction
Non-Hemorrhagic Contusion