Neuroimaging - Neurovascular Disorders, Trauma & CT Brain MCQs

Fetal Doppler US of the middle cerebral artery is used in two situations: (a) noninvasive assessment of fetal anemia and (b) calculation of cerebroplacental ratio as a measure of fetal brain sparing. In response to hypoxia, the fetus diverts blood flow to the brain, increasing the middle cerebral artery diastolic flow, thereby decreasing the pulsatility index and altering the ratio of the umbilical artery flow to the middle cerebral artery flow. Reference: A Radiologist’s Guide to the Performance and Interpretation of Obstetric Doppler US Anne M. Kennedy and Paula J. Woodward RadioGraphics 2019 39:3, 893-910

STIR technique is used to suppress fat. FLAIR technique is used to suppress fluid like CSF spaces in brain.

FLAIR sequence is a Fluid suppressing sequence used to suppress CSF spaces in the brain It evaluates Brain Edema better by suppressing the CSF signals Reference: MRI made easy page no 65

The corpus callosum is commonly involved in: Adrenoleukodystrophy: A genetic disorder that affects the adrenal glands and the white matter of the brain. Marchiafava-Bignami disease: A rare neurological disorder characterized by damage to the corpus callosum, often associated with chronic alcoholism. Progressive multifocal leukoencephalopathy: A viral disease of the brain caused by the JC virus, which can lead to demyelination of the white matter including the corpus callosum. Diffuse axonal injury: A type of traumatic brain injury that can result in widespread damage to the brain's white matter, including the corpus callosum. CNS lymphoma: Lymphomas that involve the central nervous system can affect the corpus callosum. Glioblastoma multiforme (Butterfly glioma): A type of aggressive brain tumor

The clinical scenario is suggestive of Zellweger syndrome (cerebrohepatorenal syndrome). In this disease, H2O2 mediated peroxisomal beta-oxidation of very long chain fatty acid is affected. Beta-oxidation in peroxisomes is differentiated from that occurring in mitochondria by the formation of H2O2. Beta-oxidation of fatty acids in peroxisomes is not coupled to ATP synthesis. The high potential electrons are transferred to O2 which yields H2O2. This syndrome is a rare inherited disorder characterized by absent peroxisomal enzymes in all tissues leading to accumulation of C26 - C38 poly ionic acids in the brain tissue Reference: Harper's Illustrated Biochemistry, 32nd Edition, Page Number-210.

Sub arachnoid spaces (SASs) are CSF-filled cavities that lie between the arachnoid and the pia. Hemorrhage into the SAS is known as subarachnoid hemorrhage (SAH ).Sometimes, blood in the SAS is refluxed into the cerebral ventricles, producing secondary intraventricular hemorrhage. The typical location of SAH (basal cisterns and sylvian and inferior interhemispheric fissures). The gross appearance of a SAH is typically characterized by blood-filled basal cisterns. Rupture of an aneurysm typically leads to SAH. KEY TAKEAWAY- Mc cause of subarachnoid Hemorrhage is Trauma. Mc cause of spontaneous subarachnoid Hemorrhage is rupture of berry aneurysm. IOC for SAH- NCCT. Reference: Osborn Brain edition 2 Brain edition 2 pg 123