• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
1
Neuroradiology Boards QuestionsThe following are True/False questions:
1995Which of the following masses are hyperdense on non-contrast-enhanced CT?1. medulloblastoma2. acoustic neuroma3. primary lymphoma4. prolactinoma*Answer: 1. true 2. false 3. true 4. falseDanhert lists medulloblastoma, lymphoma, and pituitary adenoma as hyperdense lesions.--probably secondary to calcification, hemorrhage, or dense protein. p 139Medulloblastoma on NCCT. are hyperdense, well circumscribed lesions. They haveoccational calcification and cytic degeneration. p 85The classic teaching is that lymphoma is typically hyperdense on NCCT at enhances to amoderate degree. This can be a little more variable in the HIV population. p 92On CT , amicroadenoma is hypodense compared to normal gland. Macroadenomas havethe same signal characteristics but have a higher propensity for hemmorrhage and infarctionbecause of the marginal blood supply. p314 requisites, 442 LeeAcoustic neuromas can be seen on CT with contrast because it diffusely enhances.Intracanilicular acoustics are difficult to ID on CECT. Basically, CT is best for ID bone erosion.p 493ref: Danhert, p 139, Requisites, p 313-4, 85, 92, p 442 , 493Lee and Rao1993 c PreTestThe pterygopalatine fossa communicates with the:5. infratemporal fossa via the pterygomaxillary fissure6. oral cavity via the pterygopalatine canal7. orbit via the superior orbital fissure8. middle cranial fossa via the foramen ovale9. inferior meatus of the nasal cavity via the sphenopalatine foramen*Answer: 5. True 6. True 7. False 8. False 9. FalseThe pterygopalatine fossa is a small pyramidal space situated below the orbital apex. It isextremely important, as it communicates withmultiple fissures, canals, and foramina, including:1. the infratemporal fossa, via the pterygomaxillary fissure2. the oral cavity, via the pterygopalatine canal3. the orbit, via the inferior orbital fissure4. the middle cranial fossa, via the foramen rotundum and the vidian canal
 
25. the superior meatus of the nasal cavity, via the sphenopalatine foramenThe pterygopalatine fossa contains the pterygopalatine ganglion and the distal portion of the internal maxillary artery.It is obvious that once a malignant neoplasm reaches the pterygopalatine fossa, it mayeasily spread to a wide variety of anatomic locations.Reference: Harnsbarger, pp. 390-391, Requisites, p 383*1995Regarding parotid gland neoplasms:10. Warthin’s tumor commonly has perineuralspread11. Warthin’s tumor is the most common parotid gland neoplasm12. pleomorphic adenomas are typically medial to the facial nerve13. pleomorphic adenoma is more common in womenanother question on spread???*Answer: 10. False 11. false 12. false 13. true80% of tumors are benign, 80% are pleiomorphic adenomas, 80% are in the superficiallobe of the parotid, 80% of pleiomorphics are in the parotic, 80% of pleiomorphics if left unRx'ed stay benign.The portion of the parotid that extends deep to the plane of the facial nerve is the deeplobe. The superficial lobe extends from just under the skin. These lobes don't really exist but arearbitrary distinction for surgical purpose. If the tumor is in the superficial lobe, the facial nerveis dissected out deep to the mass and the tumor is resected superficial to the facial nerve. Aremost commonly seen in middle aged women. p 414, 420Warthin's tumor is nearly exclusive to the parotid and is the most common multiple andbilateral tumors in the gland. These lesions are entirely benign. Warthins are most commonlyseen in elderly men. p 420 They are the second most common benign tumor of the parotic--10%as stated in Danhertp 256. These lesions are usually round to oval encapsulated masses. p 824Robbinsref: Requisites p 420, 414, Danhert p 256, Robbins, p 8241995Regarding Neurofibromatosis Type I14. acoustic neuroma15. sphenoid wing dysplasia16. optic nerve glioma17. macrocrania*Answer: 14. false 15. true 16. true 17. trueNF-1 is von Recklinghausen's disease. To dx must have two or more of the followingfindings-->6 cafe au lait spots, >2 lisch nodules of the iris, >one plexiform neurofibroma,
 
3axillary freckling, >one bony dysplasia, pseudarthrosis of long bone, optic glioma, 1st degreerelative with NF. Acoustic neuroma is associated with NF-2.ref: Requisites p 266The orbit frequently displays a characteristic unilateral defect fo the greater and lesserwings of the sphenoid attributed to underlying mesodermal dysplasia. Other cranial abnormalitiesinclude bone defect along left side of the lambdoid suture, hypoplastic maxillary and ethmoidsinuses. Themandible and maxilla may be affected by overlying soft tissue abnormalities. p1220 Resnick.Macrocraniumis seen in 75%. Manaster p 3261995Which of the following are migrational abnormalities?18. schizencephaly19. heterotopic bands20. alobar holoprosencephaly21. Chiari II malformation22. unilateral megaencephaly*Answer: 18. true 19. true 20. false 21. false 22. trueSchizencephaly is a abnormality of neuronal migration is the 5-7th week. It is a cleft seencoursing from the ependyma to the pial surface. The disorder is secondary to failure of thegerminal matrix to form. p 253Heterotopia is usually in the gray matter which is located in the wrong place due to arrestin neuronal migration. This usu occurs in the 7th to 16th week when migration of the neuroblastsform the perivent to the pia is thwarted. Ectopic gray matter is usually in the subependymal orsubcortical location. p 256Holoprosencephaly is a congenital abnormality where separation of the right and leftcerebral hemispheres is incomplete. Alobar type is the most severe and demonstrates almost noseparation of the cerebral hemispheres and ventricles. There is one large horseshoe shaped ventwith no interhemispheric fissure. The BG and thalamus are fused. p 252Etiologies of unilateral cranial enlargement--Dyke-davidoff-masson syndrom,hemimegalencephaly(neruonal migrational anomaly), NF, Klippel-Trenaunay Synd, ProteusSydrome. Can get polygyria associated with hemispheric size, or agyria associated with less severhemispheric enlargment. MR demonstrates distorted thickened cortex with ipsilateral ventriculardilatation. p 258Chiari malformation is dx when cerebellar tonsils are below the foramen magnum. ? noetiology stated. p 261ref: Requisites
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...