1When do you use contrast for brain imaging?
infection
tumor
multiple sclerosis
2CT is better for?
facial evaluation
(also cheaper and faster)
3MRI is better for?
tissue differntiation
4MRI is better for which type of trauma?
subacute
5What does blood appear on CT?
white
6What is evaluated on glasgow coma scale?
Eye opening (1-4)
verbal response (1-5)
motor response (1-6)
7What is a normal number for the glasgow coma scale?
15
8What are common dangerous mechanisms of head injury?
pedestrian struck by motor vehicle
occupant ejected from motor vehicle
fall from >3 feet or >5 stairs
9What are the signs for basilar skull fracture?
hemotypanum
raccoon eyes (periorbital ecchymosis)
battle's sign (mastoid ecchymosis)
Halo sign (CSF oto-/ rhinorrhea)
10When do you exclude the canadian head CT criteria?
less than 16
on anticoagulants (give CT regardless)
post traumatic seizure (give CT regardless)
11When would you invoke the canadian head CT rules?
GCS 13-15 with LOC
amnesia of the head injury event
confusion
12What is the high risk criteria?
GCS < 15 at 2 hours post injury
suspected open or depressed skull fx
basilar skull fracture sign
> one episode of emesis
age is 65 or older
13What is the medium risk criteria?
retrograde amnesia > 30 min
dangerous mechanism of injury
14When do you use contrast for brain imaging?
infection
tumor
multiple sclerosis
15Intra-axial means?
within brain parenchyma
16Extra-axial means?
outside brain parenchyma but within potential spaces (epidural, subdural, subarachnoid)
17What is intraventricular?
blood in ventricle
18What is an epidural hematoma and how does it present on CT?
bleed between skull and dura
typically crescentic whitish mass, covex to brain
19What is a subdural hematoma and how does it present on CT?
bleed between dura and arachnoid membranes
typically concave to brain surface, paralleling the surface of the skull
20Which subdural hematoma has the worst prognosis?
acute
21What is a subarachnoid hemorrhage?
bleed between arachnoid and pia mater
22What is the difinitive diagnosis for a subarachnoid hemorrhage?
lumbar puncture
23What is typically associated with subarachnoid hemorrhage?
thunderclap headache associated with n/v, progressive LOC, neurological decline
24How does a subarachnoid hemorrhage form?
trauma
spontaneous from ruptured aneurysm
25In brain trauma when is the mass effect an emergent situation?
midline shift away from lesion or bleed
26What are some physical abnormalities most offten associated with brain abnormalities?
macrocephaly
abnormal facies and cleft palate
meningocoele
27What is "bad black brain" ?
associated with cerebral edema
no grey white matter distinction indicating a global hypoxic ischemic event
bad prognosis
28What is the most common vascular condition affecting the brain?
stroke
29What are the two types of stroke?
ischemic
hemorrhagic
30Ischemic can develop into?
hemorrhagic
31What is the first line imaging modality for stroke? What is its purpose?
CT
differentiate between ischemic and hemorrhage
32T2 and FLAIR sequences show white where damaged tissue exists d/t...
leakage of water by damaged ischemic cells
33For imaging tumors what is done initially?
CT w and w/o contrast
34What follows CT?
MRI with gadolinium
35Extra-axial tumors display...
widest base at brain surface, typically related to the meninges or bones of skull
36Tumors completely enveloped in brain tissues usually of ____ ____ orgin?
glial cell
37What is the first line imaging for congenital anomalies?
CT followed by MRI
38what are some brain abnormalities?
hydrocephalus
abnoraml forebrain development
meningocele
39What are some physical abnormalities most offten associated with brain abnormalities?
macrocephaly
abnormal facies and cleft palate
meningocoele