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Learn about the radiographic appearances and clinical correlations of inflammatory diseases like meningitis and encephalitis, as well as congenital conditions such as Spinal Bifida. Explore imaging modalities, prognosis, and diagnostic techniques for various CNS disorders.
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CNS Pathology RT 91 Spring 2013 Final
INFLAMMATORY DISEASE OF CNS Meningitis Encephalitis
Radiographic Appearance: Meningitis • Initially meninges show vascular congestion, edema and minute hemorrhages • MRI and CT scans could appear normal if appropriate therapy is done right away Meningitis as a result of a Staph infection
Encephalitis • MRI is modality of choice • Results in cerebral edema and hemorrhagic lesions • More serious than meningitis because it frequently develops permanent neurologic disabilities
CONGENITAL DISEASES OF CNS Spinal Bifida
Types of Spinal Bifida • What is the differences between the types? • What is the prognosis? • What are modalities used to diagnose?
Radiographic Appearance Meningomyelocele • Can be demonstrated with CT, MRI and myelography • Prenatally with ultrasound (in utero) • Large bony defects • Herniated spinal contents Meningocele
CRANIAL AND SPINAL FRACTURES • Linear • Depressed • Basilar • Compression Fracture of spine • Hangman’s Fracture • Jefferson’s Fracture
Jefferson’s Fracture
TRAUMATIC DISEASE • Contusion • Hematoma • Epidural • Subdural
Epidural Hematoma Usually a shift of midline Toward opposite side CT shows increased density Emergency surgical decompression is required to relieve cranial pressure
Subdural Hematoma Occurs more slowly Because it is a venous Hemorrhage. On CT appears as a curvilinear area of I increased density on portions or all of the cerebral hemispheres
Degenerative Diseases Herniated Disk
Herniated Disk • MRI is modality of choice • CT and Myelography can also be used
Brain & Spinal Tumors Intramedullary Extramedullary
Extramedullary Spinal Tumors Meningioma Neurofibroma
Intramedullary Spinal tumors Astrocytoma Ependymoma
Brain Tumors • In children 20% of all tumors are brain tumors • 60 – 70% are located in the cerebellum & posterior fossa • Most common are astrocytomas, medulloblastomas, glioblastomas and craniopharyngliomas • 30% of primary ped. Tumors are medulloblastoma • In adults most prevalent are: • Astrocytomas, glioblastomas, metastatic tumors and menigiomas
Astrocytomas of Brain Usually treated with surgery and radiation therapy Have good 5 year survival rate
Ependymoma of Brain Usually treated with surgical removal
Other CNS • Hydrocephalus • Multiple Sclerosis • CVA
Treatment of Hydrocephalus • Placement of a shunt • Internal jugular, heart or peritoneum • Contains one way valve to prevent backflow of blood into ventricles • Radiographs taken to verify shunt placement • CT or MRI done to evaluate success of treatment Ventricularjugular Shunt
HALLMARKS OF MS : SPINAL CORD BRAIN DEMYELINATION AREAS