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31 Cards in this Set

  • Front
  • Back
List 4 radiological discovery of Mass Effect in brain
1. effacement of sulci
2. ventricular compression
3. midline shift
4. hydrocephalus
What are intra-axial mass and extra-axial mass?
What effect do they have on brain tissue?
Intra-axial = within the brain
Extra-axial = outside the brain

Intra-axial : expanding the brain
Extra-axial : compressing the brain
When a tumour is inside the brain, we call it _________ tumour.
When a tumour is outside the brain, we call it ___________tumour
How to distinguish intra-axial mass from extra-axial mass?
Intra-axial Extra-axial
Cortex Toward skull Away from
Contrast enhancement
variable marked
Gyral broadening Broad contact with dura/bone
Dural feeding arteries
Give 4 common intra-axial masses
1. metastasis/tumour
2. hematoma
3. abscess
4. infarct
Give 2 common extra-axial masses
1. epidural/subdural hematoma
2. meningioma
What can a disease with multiple intra-axial calcification with no mass effect be?
What can we see in the imaging of neurocysticercosis?
Multiple calcification
Give 3 mass effects which are neurologic emergency.
1. Herniation
2. Compression of important structure (i.e. optic chiasm)
3. Obstructive hydrocephalus (i.e. cerebellar medulloblastoma)
Give 4 common types of brain herniation
1. subfalcine
2. transtentorial
3. tonsillar
4. uncal
Give 4 causes of brain abscess
1. haematogenous
2. direct extension
3. penetration
4. cryptogenic/idiopathic
What is the location of brain abscess from hemotogenous source?
At the grey/white junction.
What can we see from plain CT of brain abscess?
Surrounding edema
What can we see from contrast CT of brain abscess?
1. Ring enhancement
2. thin wall
What can we see from MRI of brain abscess?
1. Ring enhancement
2. Hypointense rim
3. Central high signal intensity on T2W due to liquefaction
What will steroid do on the imaging of brain abscess?
It suppresses edema, and supressed ring enhancement in contrast CT
Give 2 complications of brain abscess
1. daughter abscesses
2. ventriculitis
Where is CSF produced?
Choroid plexus in lateral ventricle
What are the 2 main types of hydrocephalus
1. Communicating / non-obstructive
2. Obstructive / non-communicating
What is communicating hydrocephalus?
Blockade beyond the 4th ventricle, in subarachnoid
What is obstructive hydrocephalus?
Blockade in ventricular system
What is the mechanism of obstructive hydrocephalus?
Reduced absorption in arachnoid granulation
What is the mechanism of communicating hydrocephalus?
1. CSF overproduction
2. imparied venous drainage
3. congenital absence of arachnoid granulation
How to distinguish between communicating and obstructive hydrocephalus in imaging
1. ventricular dilation: proximal to blockade in obstructive, symmetriacl dilation of all ventricles in communicating

2. colloid cyst in non-communicating
In hydrocephalus, what imaging indicate acute worsening?
Transependymal migration of CSF into brain parenchyma
What is the significance of transpendymal migration of CSF into brain parenchyma in brain imaging?
Acute worsening.
Is hydrocephalus always accompanied with high pressure?
Normal pressure hydrocephalus can happen (in elderly?).
Which is more common, obstructive or communicating hydrocephalus?
Obstructive hydrocephalus is much more common
What is normal pressure hydrocephalus?
A form of chronic communicating hydrocephalus (where new CSF ciruculation equilibrium is established)