CNS NOTES

“ADRENOLEUKODYSTROPHY”

“ Typically affects boys aged 5-10 years.  The most common mode of inheritance is X-linked recessive.  The disease starts around the lateral trigones.  Coexists with adrenal insufficiency (neurological symptoms appear first). Death occurs within 2 years. MRI •  Preferential symmetrical involvement of the optic and auditory pathways, the splenium of the corpus callosum, posterior periventricular …

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Orbital pseudotumor 848

“ This affects adults and is due to lymphocytic infiltration. It causes a painful, proptosed and paralysed eye. The lacrimal gland is the most frequently affected. It is associated with retroperitoneal fibrosis, Wegener granulomatosis, sarcoidosis and fibrosing mediastinitis. It may affect other parts of the skull base, meninges, nasopharynx, etc. The main differential is lymphoma. …

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“VOCAL CORD PARALYSIS”

“ This may be due to causes including iatrogenic (postoperative/intubation), trauma, thyroid/parathyroid neoplasm, lymphadenopathy and tumour. CT •  Look for medialisation of the arytenoid and adduction of the vocal cord with resulting enlargement of the ipsilateral piriform sinus.•  Atrophy of the cricothyroid muscle.•  Absent thyroid (e.g. post-thyroidectomy).” For Radiology Cases, Discussion join: Radiology Made Easy …

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“SIALOLITHIASIS”

“ Up to 90% of stones are found in Wharton’s ducts in the submandibular gland. Stones are typically solitary and radiopaque. Sialolithiasis may be complicated by abscess or sialadenitis. US • Echo-casting calculus with duct dilatation SIALOGRAM • Obstructing filling defect/opacity ” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel …

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FIVE THINGS TO LOOK FOR IN THE CERVICAL SPINE WITH RHEUMATOID ARTHRITIS (RA)

“ 1.  Atlantoaxial instability (C1 transverse ligament destruction by pannus). Frank instability in 5% with RA. Shown by pre-dentate space >2.5 mm in adult. 2.  Atlantoaxial impaction: severe atlantoaxial subluxation with collapse of the C1-2 facets and basilar invagination. Look for anterior slip of C1 so the anterior border of C1 lies anterior to the inferior border …

FIVE THINGS TO LOOK FOR IN THE CERVICAL SPINE WITH RHEUMATOID
ARTHRITIS (RA)
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“Capillary hemangioma of the orbit (INFANTILE)”

“ These typically regress after 2 years. They increase in size with Valsalva and large lesions consume platelets. CT •  Lobular lesion that enhances intensely MRI •  Prominent curvilinear flow voids ” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case discussion  Join our Telegram …

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“CEREBRAL CALCIFICATION”

“ May occur with hypo- or hyper-parathyroidism, Fahr disease, post-anoxia, neonatal AIDS or Cockayne disease. CT •  Look for calcification elsewhere, suggesting a systemic problem.” For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case discussion  Join our Telegram group: Radiology Made Easy   

“SPINAL STENOSIS”

“ This often coexists with disc disease. Central stenosis is mostly the result of bilateral facet joint degeneration causing a slip. Other than degeneration, possible causes include Paget disease, spondylolisthesis and trauma. Superior facet hypertrophy may cause a lateral recess stenosis. MRI •  Facet joint degeneration (loss of disc space) and hypertrophy•  Spondylolisthesis•  Thickening/buckling of …

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FACETAL CYSTS

Facet joints degenerate like any other synovial joint. Facetal cysts may form containing fluid, blood or air and thus demonstrate a variable signal on magnetic resonance imaging. For Radiology Cases, Discussion join: Radiology Made Easy on Facebook  Subscribe to our youtube channel for FRCR radiology case discussion  Join our Telegram group: Radiology Made Easy   

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