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Kuliah Unpad Dr. Farhan
Kuliah Unpad Dr. Farhan
NEURORADIOLOGY (NEUROIMAGING)
Plain Film
CT Scan
(Computed tomography)
MRI
(Magnetic Resonance
Imaging)
Angiography / DSA (Digital
Subtraction Angiography)
Sonography / USG / Color Doppler
Nuclear Medicine
PLAIN FILM/CONVENTIONAL
RADIOLOGY
SKULL : -
Lateral view
Sella
Straight posteroanterior view
Caldwell view
Towne view
Basal (submentovertex) view
Waters view
LATERAL VIEW
Sutures
Calvarium
Sella
Dorsum sellae
Sinus sphenoidalis
STRAIGHT POSTEROANTERIOR
VIEW
CALDWELL VIEW
Lesser - greater wings
Foramen rotundum ( V2 )
Orbital rim
Zygoma - zygomaticofrontal
suture
Floor of anterior cranial fossa
Frontal sinus
TOWNE VIEW
Occipital, parietal, frontal
Sagital suture
Posterior clinoid processes dorsum sellae
Internal auditory canal
WATERS VIEW
Maxillary - frontal sinuses
Orbital margin zygomaticofrontal suture
Zygomatic process
Body, ramus, condyle,
coronoid process
BASAL (SUBMENTOVERTEX)
VIEW
Odontoid
Middle fossa
Foramen ovale ( V 3 )
Foramen spinosum ( mma )
Sphenoid sinus
- Osteopetrosis
- Hematologic; anemias,
myelofibrosis
- Fibrous dysplasia
- Paget's disease
- Acromegaly
- Metastasis
- Dilantin
- Hypervitaminosis D
Osteoma
Hyperostosis frontalis
Meningioma
Fibrous dysplasia
Paget's disease
Metastasis
Calcified cephalhematoma
B. Phatologic calcifications
1. Tumors
a. O1igodendriglioma (90%)
b. Craniopharyngioma (70%)
c. Ependymoma (60%)
d. Choroid plexus papilloma (25%)
e. Low-grade astrocytoma (20%)
f. Meningioma (10%)
g. Other (Dermoid, pineal tumor,
lipoma)
B. Phatologic calcifications
2. Infection : CMV, toxoplasmosis,
cysticercosis
3. Vascular :
a. Atherosclerotic disease
b. Aneurysm
c. Arteriovenous malformation
4. Pathologic basal ganglia
calcification
B. Phatologic calcifications
5. Neurocutaneous
syndromes
a. Neurofibromatosis
b. Sturge-Weber
syndrome
c. Tuberous sclerosis
V. Large Sella
DDX :
Tumor : Adenoma,
craniopharyngioma, optic nerve
glioma
Aneurysm
Increase intracranial pressure
Empty sella
CEREBROVASCULAR DISEASE
I. Cerebral Infarction
a. Etiology
1. Atherosclerosis (large
vessels)
2. Atherosclerosis (small
vessels)
3. Hypoxia / anoxia
4. Dissection
CEREBROVASCULAR DISEASE
I. Cerebral Infarction
a. Etiology
5. Fibromuscular dysplasia
6. Vasculitis
7. Basal arteriovascular occlusiv disease
8. Venous thrombosis
9. Miscellaneous; vasospasm, trauma
Vascular distribution
Evidence of cytotoxic edema
Involvement of cortex
Hemorrhagic transformation
V. Cerebrovascular Malformations
1. Capillary telangiectasis
2. Cavernous angioma (hemangioma)
3. Venous angioma
4. Arteriovenous malformation (AVM)
5. Occult cerebrovascular malformation
(cryptic AVM)
6. Vein of galen aneurysm
CRANIAL TRAUMA
1. Imaging
Skull film, CT, MRI
2. Type of Injuries
a. Direct
b. Indirect
c. Skull fractures
CRANIAL TRAUMA
3. Types of the Hemorrhages
a. Appearance of hemorrhage by
CT
b. Appearance MR
c. Extra axial hemorrhage
Aneurysm rupture
AVM rupture
Hypertension
Hemorrhagic infarct
Hemorrhagic tumor
Bleeding diathesis
Amyloid angiopathy
INTRACRANIAL MASSES
1. Radiografic Characteristic of Lesion
a. Intrinsic CT density
b. Contrast enhancement
BBB
(ring, gyriform, homogenous)
c. Multiple lesions
d. MR appearance
A. Primary Tumor
1. Glioma
a. Astrocytoma
b. Ependymoma
c. Oligodendroglioma
d. Ganglioglioma
2. Meningioma
3. Lymphoma
B. Metastatic Tumor
- Glioma
Meta
Abcess
Resolving hematoma
Resolving infarction
Homogenous :
- Lymphoma
- Aneurysm
INTRACRANIAL INFECTIONS
DISEASE
I. Focal Lesions
A. Pyogenic brain abcess
B. Atypical brain abcess
C. AIDS : Toxo, Lympho, TB,
Abcess
II.
Encephalitis
Congenital : TORCH
Toxo, CMV, Rubella, Herpes
III. Meningitis
- Primary : MS
Viral
Toxic and Metabolic
Post therapy
Vascular / SAE
B. Dysmyelinating Diseases
- Leucodystrophies
V. Congenital Anomalies
1. Scoliosis
2. Vertebral anomalies
3. Dysraphism
4. Syrinx
5. Tumors
6. Neurofibromatosis
7. Spinal stenosis
TERIMA KASIH