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neuro

This tag is associated with 21 posts

Pneumocephalus

History: male with head trauma This is the best example of post-traumatic pneumocephalus I have seen personally outside of the literature. Pneumocephalus literally just means airhead, and is caused most often by trauma (in as many as 75% of cases). The second most common cause of pneumocephalus is iatrogenic from either ventricular shunt placement or … Continue reading

Ring Enhancing Intracranial Mass Mnemonic – MAGIC DR

This is a commonly used mnemonic to recall the differential diagnosis for ring enhancing intracranial masses: M – Metastases A – Abscess G – Glioblastoma Multiforme I – Infarct (subacute) C – Contusion D – Demyelinating disease (such as tumefactive multiple sclerosis) R – Radiation Necrosis and Resolving hematoma

Depressed Skull Fracture in an Infant – Non-accidental Trauma versus Accidental Trauma

History: Infant status post fall from 4 feet. This is the appearance of a depressed skull fracture in an infant. In the setting of skull fractures in an infant, one always has to rule out the presence of non-accidental trauma (NAT), which is medical-speak for child abuse. There are multiple characteristics of skull fractures which … Continue reading

Unknown Case # 13 – Pediatric Head CT

History: 10 year old female with headaches and facial deformity.  What is your differential diagnosis for this 10 year old girl with headaches?

Solution to Unknown Case # 8 – Luckenschadel Skull versus Copper Beaten Skull

History: Infant with a congenital anomaly.  This is the appearance of a Luckenschadel (or lacunar) skull. Luckenschadel skull is a congenital defect in the skull that results from abnormal membranous ossification. It is associated with Chiari II malformations, which includes the following features: 1. Cerebellar tonsil herniation through foramen magnum due to a small posterior … Continue reading

Non-Traumatic Intracranial (Intracerebral) Hemorrhage – Differential Diagnosis

History: 28 year old patient with end stage renal disease and hypertension presents with a seizure.  This young patient had multiple areas of spontaneous, or primary intracranial hemorrhage with an absence of trauma. As indicated in the figure, intracranial (or intracerebral) hemorrhage can occur in different spaces in the head itself, including the subarachnoid space (green … Continue reading

Restricted Diffusion – Differential Diagnosis

History: 70 year old male with acute right sided hemiplegia.  Many different entities can cause increased signal on diffusion weighted imaging. The differential diagnosis includes acute ischemic stroke, abscess, empyema, epidermoid cyst, lymphoma, intracerebral hematoma, encephalomyelitis, diffuse axonal injury, meningioma, and multiple sclerosis. An excellent article reviewing these entities is found here. The patient from … Continue reading

Periventricular White Matter Hypoattenuation – Differential Diagnosis

History: 80 year old male with headache. This is the appearance of periventricular white matter hypoattenuation on CT. In this patient it is due to normal aging effects on the brain. The appearance of periventricular white matter hypoattenuation on CT is nonspecific and the differential diagnosis includes normal aging brain, arteriolosclerosis, multiple sclerosis, acute disseminated … Continue reading

Meningioma – On MRI

History: 60 year old female with headaches and dizziness.  This is a case of a meningioma with all of the classic MRI findings, except for location. Meningiomas arise from the arachnoid cap cells of the meninges. They are supratentorial in 90% of the time, which is why this case isn’t entirely a classical. Meningiomas are benign … Continue reading

Glioblastoma Multiforme – Ring Enhancing Lesion Differential Diagnosis

History: 55 year old male with new onset seizures. This case is a nice example of a ring enhancing mass in the brain. The typical mnemonic used for a solitary ring enhancing mass in the brain is MAGIC-DR which stands for Metastases, Abscess, Glioblastoma Multiforme, Infarct, Contusion, Demyelinating disease (tumefactive multiple sclerosis), and Radiation Necrosis … Continue reading