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CNS Pathology

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.

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CNS Pathology

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  1. CNS Pathology RT 91 Spring 2013 Final

  2. INFLAMMATORY DISEASE OF CNS Meningitis Encephalitis

  3. 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

  4. Encephalitis • MRI is modality of choice • Results in cerebral edema and hemorrhagic lesions • More serious than meningitis because it frequently develops permanent neurologic disabilities

  5. CONGENITAL DISEASES OF CNS Spinal Bifida

  6. Types of Spinal Bifida • What is the differences between the types? • What is the prognosis? • What are modalities used to diagnose?

  7. Radiographic Appearance Meningomyelocele • Can be demonstrated with CT, MRI and myelography • Prenatally with ultrasound (in utero) • Large bony defects • Herniated spinal contents Meningocele

  8. Meningomyelocele

  9. Spinal Bifida Imaging

  10. CRANIAL AND SPINAL FRACTURES • Linear • Depressed • Basilar • Compression Fracture of spine • Hangman’s Fracture • Jefferson’s Fracture

  11. Linear Fractures

  12. Linear Skull FX

  13. Depressed Fracture

  14. Depressed Skull FX

  15. Basilar Fracture

  16. Compression FX of Spine

  17. Compression FX of Spine

  18. Hangman’s Fracture

  19. Hangman’s Fracture

  20. Jefferson’s Fracture

  21. Jefferson’s Fracture

  22. TRAUMATIC DISEASE • Contusion • Hematoma • Epidural • Subdural

  23. Cerebral Contusion

  24. Epidural Hematoma Usually a shift of midline Toward opposite side CT shows increased density Emergency surgical decompression is required to relieve cranial pressure

  25. 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

  26. Degenerative Diseases Herniated Disk

  27. Herniated Disk

  28. Herniated Disk

  29. Herniated Disk • MRI is modality of choice • CT and Myelography can also be used

  30. Herniated Disk: Fusion

  31. Brain & Spinal Tumors Intramedullary Extramedullary

  32. Extramedullary Spinal Tumors Meningioma Neurofibroma

  33. Intramedullary Spinal tumors Astrocytoma Ependymoma

  34. 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

  35. Astrocytomas of Brain Usually treated with surgery and radiation therapy Have good 5 year survival rate

  36. Ependymoma of Brain Usually treated with surgical removal

  37. Medulloblastomas of Brain

  38. Craniopharyngliomas of Brain

  39. Metastatic Tumor of Brain

  40. Other CNS • Hydrocephalus • Multiple Sclerosis • CVA

  41. Hydrocephalus

  42. Hydrocephalus

  43. 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

  44. HALLMARKS OF MS : SPINAL CORD BRAIN DEMYELINATION AREAS

  45. Imaging of Multiple Sclerosis

  46. Multiple Sclerosis: MRI

  47. Ischemic Stroke

  48. Hemorrahgic Stroke

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