Neuroradiology #25 – Flashcard

What do you see? What is the most likely diagnosis?

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Multiple sclerosis

Multiple white matter lesions involving the corpus callosum, peri-trigone region, subcortical, and deep white matter.
Ddx: other demyelination, vasculitis, small vessel disease, tosic/metabolic, watershed infarcts.  

Neuroradiology #24 – Flashcard

89-year-old female patient with aplastic anemia. Showing CT images without contrast media. What do you see?

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CT images without contrast media: Subacute isodense right subdural hematoma, revealed with narrowing of right cerebral hemispheric sulci and right lateral ventricle and minimal midline shift (red arrows), acute left subdural hematoma (blue arrow)

Neuroradiology #22 – Flashcard

What do you see on these images?

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Oligodendroglioma

CT scan shows a large calcified lesion. MRI shows a large cortical-based high T2 lesion with cystic component and dark T2 foci corresponding to the calcifications. Post-contrast images show patchy enhancing areas.  

Differential Diagnosis

DNET (usually may calcify) ganglioglioma (cystic areas, enhancing solid component, may calcify).

Neuroradiology #17 – Long case

Regarding the following images:

Where is the abnormality?

Bilateral asymmetrical temporal and inferomedial frontal lobes and insular cortices

What is it like?

Abnormal CT hypodensity and high FLAIR signal intensity of the affected white matter and cortex

What is the differential diagnosis?

Herpes encephalitis: affects the limbic system bilaterally, temporal lobes, insular cortices and inferolateral frontal lobes. May progress to hemorrhage. Basal ganglia is typically spared

Paraneoplastic tumor-related limbic encephalitis and autoimmune limbic encephalitis: tumour-related limbic encephalitis and autoimmune limbic encephalitis: autoimmune encephalitis. Same distribution as herpes encephalitis but the basal ganglia is frequently involved. Hemorrhage is uncommon

What is the final diagnosis?

Herpes encephalitis