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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.
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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