Neuro and Head and Neck – Autumn 2012
- Young woman involved in RTA, weakness in hands, cystic lesion next to spinal cord with cord in opposite direction – which level is the lesion:
 - C4/5
 - C5/6
 - C6/7
 - C7/T1
 - Old accident with non specific arm symptoms, fluid filled spaces at C6/7 exit foramina with nerve roots not visualised and weakness in right distribution –
 - Nerve root avulsion
 - Torlov cyst
 - MRI for brain lesion 3-4/52. Now presents with pain and itching over foot, ankle, red indurating rash, parasthesia and SOB on lying flat and upright
 - NSF
 - Sarcoid
 - Young man, headache, supra anterior part of 3rd ventricle, hyperintense on CT- Colloid cyst
 - Young woman with parotid mass, unilateral, multicystic, low on T2
 - Pleomorphic adenoma
 - Diabetes insipidus, which lesion can it not be ? LCH
 - Midline mass mainly cystic with some Calcs closely assoc with pineal gland
 - dermoid
 - pineoblastoma
 - germinoma
 - pineocytoma
 - subarachnoidhaermorrhage 2/52 ago, MRI appearances
 - What is best sequence of vertebral artery dissection
 - Time of flight
 - 2D/3D gad enhanced
 - T1 Fat sat
 - T2 Fat sat
 - Young man, cystic lesions in parotids bilaterally with bilateral Lymph nodes
 - Sarcoid
 - HIV
 - TB
 - Warthins
 - Young man in RTA, intracranial blood at vertex crossing the midline, straddling the falx
 - Intercerebralparafalcine
 - Subdural
 - EDH
 - Combined
 - 41 year old man with seizures, symmetrical high T2 hyperintensities in ext capsule, periventricular and temporal
 - cadasil
 - Moyamoya
 - SLE
 - Facial rash and seizures – SLE
 - Tram track calc in optic sheath – NF2
 - 80 year old man mass in corpus callosum with T2 changes in periventricular regions ?lymphoma/GBM
 - 16 year old girl, confusion, low attenuation ring enhancing lesions on T2- abscess
 - Arachnoid cyst – CSF density, no restriction, disappears on FLAIR
 - Epidermoid at CPM – restricts on DWI
 - Post trauma, which on is abnormal
 - Air in Prussak
 - Air in ventricle
 - Air in epitympanic recess
 - Fluid in cochlear
 - CN6/7
 - Clivalchondrosarcoma
 - Cavernous sinus meningioma
 - Facial nerve schwanomma
 - Positive cavernoma
 - Midbrain demyelination
 - MS – optic neuritis, now loss parathesia? Where is the lesion in the brain?
 - Calloseptal interface
 - Cortical
 - Bells’ palsy – which part of the facial nerve enhances?
 - 80 year old man. Lytic, sclerotic and subperiosteal bone resorption. Peripheral soft mass, past medical history.
 - Bisphophanate
 - Ameloblastoma
 - Osteonecrosis
 - Dentigerous cyst
 - Orbital pseudotumourvs thyroid
 - Not involvement
 - Involvement of lacrimal
 - Single muscle
 - Extraconal
 - Lymph node levels –
 - Above hyoid
 - Tonsillar cancer
 - Level II/III
 - Nasopharyngeal cancer. RCA totally occluded, left carotid – 90%
 - Medical
 - Stenting on right
 - Endarterectomy
 - Surgical revasc
 - Endovasc stenting
 - Alobarholoprosencephaly
 - Difference between benign intracranial hypertension and sagittal sinus thrombosis
 - Subtle bleed in ventricle
 - Prominent temp horns
 - Slit like lateral ventricles
 - Bilateral haemorrhages
 - Pregnant pre eclampsiapt then cortical thickness where is the lesion – bilateral occipital haemorrhages
 - Young man with HIV, nodular enhancement of basal ganglia
 - Cypto
 - Toxo
 - HIV encephalopathy
 - Badly controlled DM and hypertension- CSF spaces in basal ganglia, no DWI
 - Perivascular
 - Lacunar infarcts
 - Enhancement of leptomeninges, nodular enhancement of spine – sarcoid
 - Soft tissue calc in hip and calc lesion in brain and oedema – neurocystercis
 - MRI/CT of sagittal sinus thrombosis
 - CNIII palsy, then SAH – where is aneurysm?
 - ACOM
 - Ophthalmic artery
 - Horner syndrome – T2 crescentic high signal
 - Differential BP, collapse when playing golf, reveral of flow in left vertebral, biphasic in axillary artery, biphasic is brachial
 - HIV encephalopathy
 - HIV – PML
 - Seizures in young man, temporal lobe lesion – DNET
 - Thoracic cord lesion extramedullary, intradural mass does not affect exit foramina ?
 - Neurofibroma
 - Meningioma
 - Dural fistula vs AVM
 - Cerebellar atrophy with T2 hyperintense ring, ataxia, hameosisderin
 - Anti-onconeuroantibodies in CSF – where is the primary – breast, lung, colon, thymoma
 - High T2 in mesial temporal lobe and confusion – paraneoplastic syndrome
 - Bronchus
 - Breast
 - Renal
 - Thyroid
 - Melanoma
 - Describe mesial temporal sclerosis – small hippocampus with high T2
 - B12 deficiency – signal change in dorsal columns, loss in T1 in vertebral bodies
 - Thyroid, calc, positive lymph node, young woman - papillary, medullary, nothing?
 - Parathyroid PTH raised, raised calc but US normal – what next? PET,CT, MRI, sestamibi
 - Lymph node, Level II- normal mediastinoscopy – FNA – SCC, CT Normal, what next? PET/CT
 - Something moves PPS forward – where is the lesion? Parotid, masticator, carotid, retropharayngeal
 - Describe paraganglioma – pulsatile tinnitus, flow voids, avid enhancement
 - CN6 palsy, retrobulabar pain and otitis media, fluid in mastoid and middle ear, ill defined change in petrous apex
 - mastoiditis,
 - Cholesterol granuloma
 - Petrous apex apicitis
 - Cholesteotoma – area least likely to be involved – semi circular canal
 - HMPAO SPECT – post temporal and parietal low activity and reduced in frontal area –
 - Alzheimers
 - Lewy body dementia
 - RTA – mass, swelling in eye – carotico cavernous fistula
 - CN 7 supplies all these muscles except one – masseter
 - Antrochoanal polyp
 - 15 year old boy, widened pterygopalatine fossa – juvenile angiofibroma
 - Cyst at base of tongue – homogenously enhancing
 - Thornwaldt cyst
 - Thyroglossal
 - Lingular thyroid
 - What structures would definitely be missing in radical neck dissection
 - SCM and submandibular
 - Digastric and parotid
 - Medial part of clavicle
 - Mandible
 - Carotid
 
