Neuro-Radiology Differentials

CONGENITAL INFECTIONS
CMV – central calc
Toxoplasmosis – peripheral calc
Ruebella – both
Herpes – none
VaricellaH. flu – subdural hygroma

AIDS RELATED CNS DZ
Toxoplasmosis
HIV Encephalopathy
Progressive Multifocal Leukoencephalopathy – papova virusI’
CNS Lymphoma

DEMYELINATING DISEASES
Multiple Sclerosis
Aquired Disseminated Encephalomyelitis
Progressive Multifocal Leukoencephalopathy – papova virus
Toxic – Etoh,
Wernicke’s,
osmotic myelinosis
TraumaVascular – PVL,
necrotizing leukoencephalopathy,
Binswanger’s, SLE

DYSMYELINATION DISORDERS
Metachromatic Leukodystrophy – lysosomal, deep confluent, hypo thalami
Krabbe Dz – lysosomal, deep confluent, hyper thalami, rapid
Adrenoleukodystrophy – post to ant
Alexander’s Dz – inclusions, ant to post
Canavan’s Dz – spongy degen, U fibers 1st
Amino Acid Deficiency – phenylketonuria, maple syrup urine, homocystinuria

DIFFUSE AXONAL INJURY
Corticomedullary Junction – frontal, temporal
Corpus Callosum – post body & spenium
Pons & Dorsal Midbrain

VASCULAR COLLATERALS
Circle of Willis
Ophthalmic
Meningeal

MRI STAGES OF HEMORRHAGE
T1 T2Hyperacute 4wks Dark Dark Hemosiderin

CT STAGES OF HEMORRHAGE
Hyperacute – 2-3hrs, i
sodenseAcute – 3hrs to 2wks,
hyperdense (60-100HU, dec by 1.5HU/d)
Subacute – 2-4wks, isodense
Chronic – >4wks, hypodense

PARENCHYMAL HEMATOMA
Trauma
Hypertention
Infarct
Aneurysm
AVM
TumorBleeding Diathesis
Amyloid

SKULL BASE LESIONS
Chordoma
Chondrosarcoma
Squamous Cell
Schwannoma
Meningioma
Mets
Glomus

POSTERIOR FOSSA MASS IN A CHILD
Medulloblastoma – hyperdense, no calc
Ependymoma – plastic, calc
Pilocytic Astrocytoma – cyst & nodule
Brainstem Glioma

POSTERIOR FOSSA MASS IN AN ADULT
Mets
Hemangioblastoma – 20% w VHL
Subependymoma
Infarct/HemorrhageAbcess

CEREBELLOPONTINE ANGLE MASS
Schwannoma – 7/8,
vest of VIII 75%,
facial 4%
Epidermoid
Arachnoid Cyst
Meningioma

CEREBELLAR DYSPLASIA’S
Cebellar atrophy
Chiari IV Malformation
Joubert’s Syndrome – split vermis
Rhomboencephalosynapsis – absent vermis
Tectocerebellar Dysraphia – hypoplastic vermis, cb rotated ant lat to stem
Lhermitte-Duclos Dz – gangliocytoma

PINEAL TUMORS
Germinoma – 60%, dense, placental alk phos
Teratoma – bothChoriocarcinoma – B-hcg
Endodermal Sin

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