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CBR Neuroradiology > 26-50 > Flashcards

26-50 Flashcards

1
Q
  1. The most common site of origin of the recurrent artery of Heubner is the

A. A1 segment,
B. A2 segment
C. internal carotid artery
D. Ml segment
E. M2 segment

A

B

Osb p. 120. The recurrent artery of Heubner (one of the medial striate arteries) takes origin from the A2 segment 34 to 50% of the time, from the A1 segment 17 to 45% of the time, and from the anterior communicating artery 5 to 20% of the time.

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2
Q
  1. lntracranial hypotension related to leakage or removal of cerebrospinal fluid (CSF) is most closely associated with which magnetic resonance finding?

A. diffuse dural enhancement
B. ependymal enhancement
C pneumocephalus
D. slitlike ventricles
E. ventriculomegaly

A

A

Yock p. 333. This enhancement is thought to represent an increase in blood volume in the dura. Inferior displacement of the structures in the posterior
fossa may accompany this finding in such cases of intracranial hypotension.

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3
Q
  1. Which of the following imaging characteristics is least likely for pleomorphic xanthoastrocytoma?

A. calcification
B. cyst formation
C. multiple lesions
D. superficial location
E. temporal lobe location

A

C

Yock p. 72. This variant of astrocytoma usually presents as a large single mass in a young patient with a long history of seizures. The other options listed are typical.

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4
Q
  1. Choroid plexus papillomas in children are most common in the

A. fourth ventricle
B. left lateral ventricle
C. right lateral ventricle
D. third ventricle

A

B. left lateral ventricle

Yock p. 204. This propensity to lateralize has not been explained. These large bulky tumors usually arise in the trigone.

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5
Q
  1. Choroid plexus papillomas in adults occur most commonly in the

A. fourth ventricle
B. left lateral ventricle
C. right lateral ventricle
D. third ventricle

A

A

Yock pp. 204-205. These tumors in the adult population are often found at the caudal aspect of the fourth ventricle and frequently calcify.

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6
Q
  1. Which one of the following white matter lesions usually initially involves the parieto-occipital regions?

A. adrenoleukodystrophy
B. Canavan’s disease
C. metachromatic leukodystrophy
D. multiple sclerosis
E. Schilder’s disease

A

A. adrenoleukodystrophy

Yock p. 252. The lesions of adrenoleukodystrophy are usually symmetrical, begin in the parieto-occipital region, and spread anteriorly.

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7
Q
  1. caudal displacement of cerebellar tonsils

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neitherC

A

C. both

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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8
Q
  1. Beaking of the midbrain tectum is characteristic.

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neither

A

B. Chiari 11 malformation

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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9
Q
  1. A meningomyelocoele is virtually always present.

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neither

A

B. Chiari 11 malformation

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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10
Q
  1. Medullary kinking is seen.

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neitherB

A

B. Chiari 11 malformation

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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11
Q
  1. Occipital or high cervical encephalocele is present.

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neither

A

D. neither

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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12
Q
  1. usually presents in young adulthood

A. Chiari l malformation
B. Chiari 11 malformation
C. both
D. neitherA

A

A. Chiari l malformation

For questions 32-37 see Yock pp. 520-521. Chiari I malformations consist of inferior displacement of the cerebellar tonsils through the foramen magnum.
They usually occur in early adulthood. In Chiari I1 malformations, the caudal displacement of the hindbrain is more severe, with beaking of the tectum and medullary kinking often seen. Myelomeningoceles are virtually always present. Chiari I1 malformations usually present in infancy. Chiari I11 malfor-mations display the most severe displacement of posterior fossa structures and are often associated with a high cervical or occipital meningocele.

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13
Q
  1. The term bovine arch refers to

A. bi-innominate arteries
B. left common carotid artery origin from the aortic arch
C. left common carotid artery origin from the right brachiocephalic trunk
D. right aortic arch
E. right subclavian artery distal to the left subclavian artery

A

C. left common carotid artery origin from the right brachiocephalic trunk

Morris pp. 99-101. The left common carotid artery usually arises from the aortic arch distal to the right brachiocephalic artery. In the bovine arch variant,
the left common carotid artery arises from the proximal right brachiocephalic artery. Variant A is rare. A right aortic arch may be incidental or associated with congenital heart disease. Variant E is associated with Down syndrome.

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14
Q
  1. The differential diagnosis of colpocephaly, or dilatation of the posterior portion of the lateral ventricles, includes
    I. agenesis of the corpus callosum
    II. Leigh’s disease
    III. periventricular leukomalacia
    IV. Hallervorden-Spatz disease
    A. I, II. Ill
    B. I, III
    C. II, IV
    D. IV
    E. all of the above
A

B. I. agenesis of the corpus callosum,

III. periventricular leukomalacia

Yock pp. 367.525. Agenesis of the corpus callosum and periventricular leuko- malacia can both result in colpocephaly. Leigh’s disease and Hallervorden-
Spatz disease can both cause symmetric lesions of the globus pallidus but are not associated with colpocephaly.

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15
Q
  1. Schizencephaly is essentially a

A. demyelinating illness
B. disease that first develops in the elderly
C. disorder of neuronal migration
D. neurodegenerative disorder
E. psychiatric disorder

A

C. disorder of neuronal migration

Yock pp. 540-522. The cleft of schizoencephaly can be unilateral or bilateral, but it usually involves the region near the central sulcus. Patients can present with seizures or focal deficits.

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16
Q
  1. The differential diagnosis of optic nerve thickening includes
    I. optic nerve sheath meningioma
    II. orbit4 pseudotumor
    III. optic nerve glioma
    IV. Graves’ disease
    A. I, II,III
    B. I, III
    C. II. IV
    D. IV
    E. all of the above
A

E.

I. optic nerve sheath meningioma

II. orbit4 pseudotumor

III. optic nerve glioma

IV. Graves’ disease

Yock p. 305. Optic nerve thickening may be caused by nonneoplastic processes like Graves’ disease, orbital pseudotumor, optic neuritis, papilledema, and vas-cular malformations, or by tumors like gliomas, meningiomas, lymphomas, leukemia, and metastases.

17
Q
  1. The most common primary benign tumor of the adult orbit is

A. cavernous hemangioma
B. dermoid cyst
C. lymphangioma
D. optic nerve glioma
E. sarcoidosis

A

A. cavernous hemangioma

Y p. 1373. Cavernous hemangiomas of the orbit are usually well demarcated, vascular, intraconal lesions with smooth or lobulated borders.

18
Q
  1. Which of the following is a branch of the ophthalmic artery?

A. anterior ethmoidal artery
B. posterior ethmoidal artery
C. both
D. neither

A

C. both

Morris pp. 135-137. The ethmoidal arteries are branches of the ophthalmic artery. They supply a portion of the anterior cranial fossa and the mucosa
of the nasal septum. During embolization of the internal maxillary artery, dangerous potential anastomoses from the sphenopalatine branches of the internal maxillary to branches of the ophthalmic artery.

19
Q
  1. Which of the following set of findings on a lumbar MRI scan performed immediately after contrast injection is most characteristic of a recurrent disk herniation and epidural fibrosis, respectively?

A. a rim of enhancement in the recurrent disk, diffuse enhancement in the fibrosis
B. a rim of enhancement in the fibrosis, diffuse enhancement in the recurrent disk
C a rim of enhancement in the recurrent disk, no enhancement in the fibrosis
D. diffuse enhancement in the recurrent disk, no enhancement in the fibrosis
E. no enhancement of either the recurrent disk or fibrosis

A

A. a rim of enhancement in the recurrent disk, diffuse enhancement in the fibrosis

Yock pp. 582-583. Scar tissue contains vascular granulation tissue that enhances more diffusely than a residual or recurrent disk.

20
Q
  1. Lesions in diffuse axonal injury are commonly found in the
    I. corpus callosum
    II. gray-white junction
    III. rostra1 brainstem
    IV. temporal lobe
    A. I, II,III
    B. I. III
    C. II, IV
    D. IV
    E. all of the above
A

A.

I. corpus callosum
II. gray-white junction
III. rostra1 brainstem

GIT p. 1426.

21
Q
  1. Acute subarachnoid hemorrhage is more difficult to diagnose on MRI than on computed tomography (m) because

A. Extracellular methemoglobin is isointense on TI and R.
B. Hemosiderin is isointense on TI and T2.
C. Most radiologists are not familiar with the appearance of acute subarachnoid hemorrhage on MRI.
D. The high oxygen tension in the subarachnoid space prevents conversion of oxyhemoglobin to deoxyhemoglobin.
E. The low oxygen tension in the subarachnoid space prevents conversion of deoxyhemoglobin to oxyhemoglobin.

A

D. The high oxygen tension in the subarachnoid space prevents conversion of oxyhemoglobin to deoxyhemoglobin.

GlT pp. 1437-1438.

22
Q
  1. Which of the following is true of the choroidal blush?

A. It is an indicator of the choroidal plexus in the lateral ventricle.
B. It is best seen on the anteroposterior projection.
C. It is from the posterior ethmoidal branches of the ophthalmic artery.
D. Its configuration is usually a thin, dense crescent.
E. Its presence usually indicates an elevated intraocular pressure.

A

D. Its configuration is usually a thin, dense crescent.

Morris p. 137. The choroidal blush signifies the choroidal plexus of the eye and is supplied by the ciliary branches of the ophthalmic artery. It is charac-
teristically seen as a thin crescent on the lateral projection of the internal carotid angiogram. Its absence can be an indirect sign of elevated intraorbital
or intraocular pressure.

23
Q
  1. The most likely etiology of this neonate’s pathology is

A. astrocytoma
B. metastatic tumor
C. Staphylococcus aureus
D. Citrobacter

A

D. Citrobacter

CNBR Fig. 3-24A, p. 177. Large neonatal brain abscesses are usually caused by Citrobacter, Bacteroides, hoteus, and various gram-negative bacilli.

24
Q
  1. identify the lesions.

A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma

A

C. fibrous dysplasia

Burg 3 Fig. 1.1, p. 2. (Courtesy of Dr. John A. Goree, Durham, NC.) Note involve-
ment of the left facial bones.

25
Q
  1. identify the lesions.

A eosinophilic granuloma
B. epidermoid cyst
C. fibrous dysplasia
D. hemangioma
E. multiple myeloma
F. osteoma

A

A eosinophilic granuloma

Burg Fig. 1.12, p. 5. (Courtesy of Dr. John A. Goree, Durham, NC.) A discrete radiolucent area is seen.

CBR Neuroradiology (6 decks)

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