Postreading Self Assessment and CME Test.25

Self-Assessment and CME
Postreading
Self-Assessment and
CME Test
Eduardo E. Benarroch, MD, FAAN; Adam G. Kelly, MD
The Continuum Postreading Self-Assessment and CME Test is an integral

part of the issue that is intended to stimulate thought and help participants
assess general understanding of the material presented in this issue. The
Postreading Self-Assessment and CME Test is also approved by the American
Board of Psychiatry and Neurology (ABPN) to meet the Lifelong Learning (CME),
Self-Assessment (SA) (part 2) component for Maintenance of Certification.
For each item, select the single best response. A tally sheet is
provided with this issue to allow the option of marking answers before
entering them online. A faxable scorecard is available only upon
request to subscribers who do not have computer access or to
nonsubscribers who have purchased single back issues (send an
email to ContinuumCME@aan.com).
Participants who complete the Postreading Self-Assessment and CME Test
and issue evaluation online at www.aan.com/continuum/cme may earn up
to 12 AMA PRA Category 1 CreditsTM toward SA-CME. Participants have up
to 3 years from the date of publication to earn CME credits. No SA-CME
will be awarded for this issue after October 31, 2019.
b 1. The pattern of hyperintensity in the fluid-attenuated inversion recovery

(FLAIR) image shown is most likely to indicate which of the following conditions?
Continuum (Minneap Minn) 2016;22(5):17011720
www.ContinuumJournal.com
Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.
1701
Postreading Test
A.
B.
C.
D.
E.
autoimmune encephalitis
Creutzfeldt-Jakob disease
CSF hypovolemia
hypoxic-ischemic encephalopathy
subarachnoid hemorrhage
b 2. A 59-year-old man is admitted to the intensive care unit with a subarachnoid

hemorrhage from a ruptured anterior communicating artery aneurysm. As
part of his screening for the development of vasospasm, transcranial Doppler
velocities in the middle cerebral arteries should be compared to velocities in
which of the following vessels?
A.
B.
C.
D.
E.
basilar artery
contralateral middle cerebral artery
contralateral vertebral artery, V4 segment
ipsilateral anterior cerebral artery
ipsilateral internal carotid artery, extracranial segment
b 3. A 52-year-old man with a history of diabetes mellitus and hypertension is

evaluated after the sudden onset of left hemiparesis. A diffusion-weighted
image obtained 6 hours after the event is shown. Which of the following is
the most likely cause of his symptoms?
Reprinted with permission from Liebeskind DS. Imaging the future

of stroke: I. Ischemia. Ann Neurol 2009;66(5):574Y590. doi:10.
1002/ana.21787. B 2009 American Neurological Association.
onlinelibrary.wiley.com/doi/10.1002/ana.21787/abstract.
A.
B.
C.
D.
E.
1702
anterior cerebral artery thrombosis

cardioembolic stroke
cerebral venous thrombosis
internal carotid artery occlusion
lacunar infarction
October 2016
b 4. On magnetic resonance spectroscopy, which of the following patterns

would be most characteristic of a neoplastic process as opposed to other
causes of brain lesions?
A.
B.
C.
D.
E.
absence of a lactate peak

decreased choline to creatine ratio
increase in the choline peak
increase in the creatine peak
increase in the N-acetylaspartate (NAA) peak
b 5. A 7-year-old girl is seen for headaches. Her headaches are posterior in

location and usually precipitated by physical activity or when she bears
down to have a bowel movement. Her developmental history has been
unremarkable, and neurologic examination is normal. Which of the following
findings is seen on this patients sagittal T2-weighted MRI of the brain?
A.
B.
C.
D.
E.
Chiari type I malformation

Dandy-Walker malformation
idiopathic intracranial hypertension
Joubert syndrome
septooptic dysplasia
b 6. The spot sign on CT imaging of patients with intracerebral hemorrhage

indicates a higher likelihood of which of the following?
A.
B.
C.
D.
E.
cavernous malformation as the cause of bleeding

early hematoma expansion
hypertension as the cause of bleeding
neoplastic process as the cause of bleeding
venous infarction as the cause of bleeding
1703
Postreading Test
b 7. A 44-year-old man is seen in the emergency department with several days

of progressive quadriparesis. His neurologic history is notable for vision loss
in the right eye 5 years ago, for which he did not seek any medical attention. His
examination shows 20/400 vision in the right eye with associated right optic disc
pallor and a right afferent pupillary defect; 3/5 power in both arms; paralysis of
both legs; and bilateral extensor plantar responses. MRI of the brain shows
minimal nonspecific T2/fluid-attenuated inversion recovery (FLAIR) white
matter hyperintensities not located in periventricular or juxtacortical locations.
Sagittal spinal short tau inversion recovery (STIR) MRI of his cervical spine is
shown. Which of the following is the most likely diagnosis?
A.
B.
C.
D.
E.
acute disseminated encephalomyelitis (ADEM)

multiple sclerosis
neuromyelitis optica (NMO)
progressive multifocal leukoencephalopathy
Sjogren disease
b 8. Which of the following MRI sequences evaluates for the random movement
of water within tissues?
A.
B.
C.
D.
E.
1704
diffusion-weighted imaging (DWI)

fluid-attenuated inversion recovery (FLAIR)
perfusion-weighted imaging
susceptibility-weighted imaging (SWI)
time of flight
October 2016
b 9. A 64-year-old woman is evaluated after awakening with right hemiparesis

and aphasia. A noncontrast CT scan performed immediately upon arrival to
the emergency department 30 minutes following detection of the event
shows a hyperdense left middle cerebral artery and no intracranial bleed. The
results of CT perfusion studies showing cerebral blood flow (CBF), cerebral
blood volume (CBV), mean transit time (MTT), and time to maximum
(Tmax), are shown. Which of the following is the most appropriate
interpretation of the set of images?
Reprinted with permission from Rowley HA. The alphabet of imaging in acute stroke: does it spell improved
selection and outcome? Stroke 2013;44(6 suppl 1):S53YS54. doi:10.1161/STROKEAHA.113.001939. B 2013
American Heart Association, Inc. stroke.ahajournals.org/content/44/6_suppl_1/S53.full.
A.
B.
C.
D.
E.
failure to develop collateral circulation

a large area of infarction
a large intracerebral hemorrhage
a large ischemic penumbra
vasogenic edema with impending risk of herniation
b 10. Which of the following conditions might result in impaired visualization of

acute cerebral hemorrhage on CT?
A.
B.
C.
D.
E.
anemia
cardiomyopathy
cirrhosis
prior skull fracture
thrombocytopenia
1705
Postreading Test
b 11. A 45-year-old man is evaluated for progressive gait difficulties, urinary

symptoms, and erectile dysfunction over the past 6 months. Examination
shows a steppage gait, weakness in L5YS1 innervated muscles bilaterally,
lower limb areflexia, loss of all sensory modalities distally in the lower limb,
perianal anesthesia, and reduced anal sphincter tone. MRI of the lumbar
spine is shown. (A, Sagittal T2-weighted image; B, sagittal noncontrast
T1-weighted image; C, sagittal postcontrast T1-weighted image; D, axial
precontrast T1-weighted image at the level of the lesion; E, axial postcontrast
T1-weighted image at the level of the lesion.) Which of the following is the
most likely diagnosis?
A.
B.
C.
D.
E.
1706
astrocytoma
cavernous malformation
dural arteriovenous fistula
Hodgkin lymphoma
myxopapillary ependymoma
October 2016
b 12. Multiple observational studies have shown a higher prevalence of

hyperintensities on nonenhanced T1-weighted scans following previous serial
gadolinium-based contrast injections in which of the following brain regions?
A.
B.
C.
D.
E.
cerebellar vermis
choroid plexus
dentate nuclei
hippocampi
mammillary bodies
b 13. A 43-year-old woman with a known pituitary microadenoma (found

incidentally on an MRI performed for headache 2 years ago) is seen in the
emergency department for severe headache, nausea, and double vision.
Examination is notable for a blood pressure of 70/49 mm Hg, loss of
sensation in the V1 and V2 distributions on the right, and a right-sided cranial
nerve VI palsy. Her sagittal noncontrast T1-weighted brain MRI is shown.
Which of the following is the most likely diagnosis?
Modified with permission from Gaillard F, Radiopaedia.org,

rID: 17664.
A.
B.
C.
D.
E.
carotid-cavernous fistula
cavernous sinus thrombosis
lymphocytic hypophysitis
pituitary apoplexy
pituitary macroadenoma
b 14. Which of the following types of cancers, when metastatic to the brain, has
the highest likelihood of hemorrhage?
A.
B.
C.
D.
E.
colon cancer
lung cancer
nonmelanoma skin cancer
ovarian cancer
renal cell carcinoma
1707
Postreading Test
b 15. A 25-year-old man is evaluated for spells characterized by behavioral arrest

and staring, which last 2 to 3 minutes. His neurologic examination is normal.
Brain MRI is also normal. A routine EEG shows bitemporal interictal epileptiform
discharges. Given the failure to respond to two antiseizure medications at
maximal tolerated doses, he undergoes a subtraction ictal single-photon
emission computed tomography (SPECT) coregistered to MRI (SISCOM) to
identify the primary ictal focus. The findings are shown in the figure below.
Which of the following is the mechanism of the abnormality found in this study?
A.
B.
C.
D.
E.
disruption of the blood-brain barrier

impaired anaerobic glycolysis
inflammatory response
relative increase in blood flow
upregulation of +-aminobutyric acid (GABA)-A receptors
b 16. A 33-year-old woman is evaluated for recent headache and pulsatile

tinnitus over the past 6 weeks. Her headache is constant and increases when
bending forward or coughing. Her body mass index is 30 kg/m2. Neurologic
examination shows bilateral optic disc swelling but is otherwise normal.
Brain MRI shows no mass lesion; however, which of the following MRI
findings is most likely to be present in this patient?
A.
B.
C.
D.
E.
1708
compression of the optic nerve sheath

enhancement of the pituitary gland
flattening of the posterior aspect of the globe
pachymeningeal enhancement
spinal root sheath diverticula
October 2016
b 17. A 28-year-old woman is seen in clinic after a recent emergency department

visit for an episode of loss of consciousness, during which she underwent a brain
MRI. She has no history of prior neurologic symptoms, her developmental
history is unremarkable, and her neurologic examination is normal. Which of the
following findings is seen on this patients coronal T2-weighted brain MRI?
A.
B.
C.
D.
E.
focal cortical dysplasia of the superior temporal gyrus

mesial temporal sclerosis
open-lip schizencephaly
polymicrogyria
right temporal lobe ependymoma
1709
Postreading Test
b 18. A 76-year-old woman is evaluated for intermittent memory difficulties over

the past 2 years. She reports occasional difficulties remembering what she was
told several minutes before or remembering names, particularly when she is in
stressful situations. However, she lives independently and is successful as the
chair of the board in her local church. From social media, the patient is aware of
the potential use of amyloid imaging for early diagnosis of Alzheimer disease
(AD) and asks whether she should undergo the procedure. Her neurologic
examination, psychometric testing, and brain MRI are normal. Which of the
following statements applies to amyloid imaging in this setting?
A. amyloid deposits have high positive predictive value as they can be seen in
less than 10% of asymptomatic patients older than 70 years
B . amyloid imaging is clinically indicated in her case given her risk for
developing AD
C. amyloid imaging is unlikely to differentiate AD from frontotemporal
lobar degeneration
D. changes in amyloid burden would correlate with progressive neurologic
deterioration over time
E . a negative amyloid imaging study may have a good negative predictive
value against AD pathology
b 19. A 25-year-old man with tuberous sclerosis complex is seen in follow-up.
On his most recent MRI, a new area of contrast enhancement in the lateral
aspect of the left lateral ventricle is seen (T1-weighted postcontrast image
shown); this abnormality was not present on his prior scan 1 year ago. His
seizure control and neurologic examination are unchanged from prior visits.
Which of the following is the most likely cause of his MRI finding?
1710
October 2016
A.
B.
C.
D.
E.
central neurocytoma
choroid plexus papilloma
ependymoma
subependymal giant cell astrocytoma
subependymal nodule
b 20. A 4-year-old-girl is evaluated for spells of transient unresponsiveness

over the past 3 months. Her development is normal, as is her neurologic
examination. EEG shows focal seizures originating in the right temporal lobe.
MRI of the brain shows a lesion located in the right temporal cortex without
associated mass effect, edema, or contrast enhancement. The lesion has a
pseudocystic or bubbly appearance that is hypointense on T1-weighted
images and hyperintense on T2-weighted images. Which of the following is
the most likely diagnosis?
A.
B.
C.
D.
E.
desmoplastic infantile ganglioglioma

dysembryoplastic neuroepithelial tumor
pleomorphic xanthoastrocytoma
primitive neuroectodermal tumor
subependymal glial cell astrocytoma ganglioglioma
b 21. An 18-year-old man is evaluated for the recent onset of intermittent

headaches. His neurologic examination is normal. MRI of his brain is shown.
Which of the following is a possible complication associated with this lesion?
A.
B.
C.
D.
E.
pituitary insufficiency
seeding to the spinal canal
seizure
sudden death
upward gaze palsy
1711
Postreading Test
b 22. Which of the following imaging characteristics is typical of the classic

Dandy-Walker malformation?
A.
B.
C.
D.
E.
absence of the fourth ventricle

hypoplasia of the cerebellar vermis
inferior displacement of the tentorium
microcephaly
smaller size of the posterior fossa
b 23. A 30-year-old woman is evaluated for right eye pain and blurred vision
over the past 2 weeks. Examination shows reduced visual acuity and a swollen
optic nerve in the right eye and a temporal field cut in the right eye. The rest
of the neurologic examination is normal. Sagittal T1 precontrast (A) and
postcontrast (B) sequences of her brain MRI are shown. Which is the
following is the most likely diagnosis?
A.
B.
C.
D.
E.
Churg-Strauss syndrome
CSF leak
Lyme disease
neurosarcoidosis
venous thrombosis
b 24. Which of the following imaging characteristics would be most consistent

with delayed radiation necrosis as opposed to tumor progression in patients
with glioblastoma?
A. enhancement with gadolinium
B . lesion development adjacent to the initial tumor site
C. lower cerebral blood volume levels on perfusion MRI
D. presence of hemorrhage
E . vasogenic edema seen on T2-weighted and fluid-attenuated inversion
recovery (FLAIR) sequences
1712
October 2016
b 25. A 72-year-old man is evaluated for the sudden onset of left hemiparesis.
On examination 3 hours after symptom onset, he has mild upper motor
neuron distribution weakness in the left upper limb. A fluid-attenuated
inversion recovery (FLAIR) MRI of the brain is obtained within 4 hours of the
event. What do the findings in this study indicate?
Reprinted with permission from Liebeskind DS. Imaging the future of stroke: I. Ischemia. Ann Neurol
2009;66(5):574Y590. doi:10.1002/ana.21787. B 2009 American Neurological Association.
onlinelibrary.wiley.com/doi/10.1002/ana.21787/abstract.
A. cortical laminar necrosis

B . hemorrhagic transformation of a cardioembolic stroke
C. slow retrograde collateral flow proximal to a middle cerebral artery
(MCA) occlusion
D. subarachnoid hemorrhage in the setting of amyloid angiopathy
E . superficial vein thrombosis
b 26. In patients with sickle cell anemia, which of the following imaging findings is
validated as being able to predict individuals at higher risk of stroke?
A.
B.
C.
D.
E.
elevated mean flow velocities in the middle cerebral arteries

Lindegaard ratio greater than 6
macaroni sign on carotid ultrasonography
presence of bilateral microembolic signals in the middle cerebral arteries
reverberating flow pattern on transcranial Doppler
1713
Postreading Test
b 27. A 72-year-old man with history of hypertension is evaluated for a 2-year

history of intermittent headaches. His neurologic examination is normal.
The arrows on this patients T2-weighted MRI (at the level of the anterior
commissure [arrowheads]) point to which of the following findings?
A.
B.
C.
D.
E.
amyloid angiopathy
dilated Virchow-Robin spaces
lacunar infarcts
microemboli
vasculitis
b 28. High-resolution MRIs of the normal pituitary gland often show an area of
T1 hyperintensity, referred to as the pituitary bright spot. Which of the
following anatomic structures does this correspond to?
A.
B.
C.
D.
E.
1714
adenohypophysis
median eminence
neurohypophysis
pituitary stalk
Rathke cleft
October 2016
b 29. A 20-year-old right-handed man is evaluated for spells characterized by

abdominal pain, dysarthria, and bradycardia. His neurologic examination is
normal. An axial fluid-attenuated inversion recovery (FLAIR) image is shown,
with the abnormalities marked with arrows. Which of the following is the
most likely pathologic substrate of these imaging abnormalities?
Reprinted with permission from Cendes F. Neuroimaging in

investigation of patients with epilepsy. Continuum (Minneap
Minn) 2013;19(3 Epilepsy):623Y642. doi:10.1212/01.CON.
0000431379.29065.d3. B 2013 American Academy of
Neurology. journals.lww.com/continuum/Fulltext/2013/06000/
Neuroimaging_in_Investigation_of_Patients_With.11.aspx.
A.
B.
C.
D.
E.
aberrant axonal sprouting

dysmorphic neurons
gliosis
immature endothelium-lined caverns
proliferation of oligodendrocytes
b 30. Which of the following time frames best approximates the average
duration that an acute multiple sclerosis (MS) lesion is expected to show
contrast enhancement on MRI?
A.
B.
C.
D.
E.
1 week
3 weeks
6 weeks
12 weeks
20 weeks
1715
Postreading Test
b 31. A 42-year-old man is seen in clinic for vision complaints. On additional

questioning, he reports a 1-year history of decreased libido and the recent
onset of gynecomastia. Examination shows subtle restriction of bitemporal
vision. A sagittal postcontrast T1-weighted image from his brain MRI is
shown. Which of the following is the most likely diagnosis?
A.
B.
C.
D.
E.
craniopharyngioma
dermoid cyst
pituitary apoplexy
pituitary macroadenoma
b 32. In brain neoplasms, restricted diffusion on diffusion-weighted MRI (ie,

reduced apparent diffusion coefficient) may be indicative of which of the
following?
A.
B.
C.
D.
E.
1716
hypercellular nature of a neoplasm

intratumor hemorrhage
lower grade of glioma
metastatic as opposed to primary brain source of neoplasm
postradiation necrosis
October 2016
b 33. A 57-year-old man is evaluated for numbness in his hands and feet and
imbalance that developed over the past 6 months. He has a history of
diabetes mellitus, hypertension, and a previous partial gastrectomy.
Examination shows a sensory ataxia with Romberg signs, areflexia, bilateral
Babinski signs, and absent joint position sense in the fingers and toes. MRI of
the cervical spine is shown. Serum methylmalonic acid levels are normal.
Which of the following is the most appropriate next test in this patient?
A.
B.
C.
D.
E.
antiYaquaporin-4 antibodies
antinuclear antibodies
serum angiotensin-converting enzyme
serum ceruloplasmin
serum vitamin D
b 34. A 54-year-old woman is seen for 1 week of right eye pain, a bloodshot
appearance to the right eye, and double vision. On examination, she has
proptosis, chemosis, and congestion of the right eye, with impairment of eye
movements in the horizontal and vertical directions. CT angiography of the
brain shows asymmetric contrast enhancement of the cavernous sinuses, with
more marked enhancement on the right; dilation of the right superior
ophthalmic vein is also seen. Which of the following is the most
likely diagnosis?
A.
B.
C.
D.
E.
right central retinal vein occlusion
right internal jugular vein thrombosis
temporal arteritis
unruptured right internal carotid artery aneurysm
1717
Postreading Test
b 35. A 12-year-old boy is evaluated for headache, vomiting, and gait disturbance.
Examination shows papilledema, impaired upward gaze, and pupillary
light-near dissociation. Sagittal MRI using T2-weighted (A) and T1-weighted
(B) sequences are shown. Which of the following diagnoses
is most likely?
A.
B.
C.
D.
E.
histiocytosis
pilocytic astrocytoma
pineal cyst
pinealoma
teratoma
b 36. A 22-year-old man is evaluated for progressive gait disturbance and hand
paresthesia over the past 3 months. Examination shows a sensory ataxia and
severe proprioceptive loss in his hands and feet. MRI of the cervical spine
shows a T1-hypointense and T2-hyperintense cystic mass lesion with a
homogeneous contrast-enhancing nodule associated with dilated vessels and
a syrinx. Which of the following is the most likely diagnosis?
A.
B.
C.
D.
E.
1718
arteriovenous malformation
cavernous malformation
hemangioblastoma
myxopapillary ependymoma
pilocytic astrocytoma
October 2016
b 37. A 31-year-old woman is seen for 3 days of worsening vision in the left eye
as well as pain with eye movements. She has had no prior episodes of
neurologic dysfunction. Examination is notable for 20/200 acuity in the left
eye, normal funduscopic appearance of the left optic nerve, and a relative
afferent pupillary defect on the left. Postcontrast fat-suppressed T1-weighted
MRI is shown. Which of the following is the most likely diagnosis?
A.
B.
C.
D.
E.
giant cell arteritis

Graves disease
nonarteritic ischemic optic neuropathy
optic nerve glioma
optic neuritis
b 38. A 68-year-old man is evaluated for progressive memory difficulties over

the past 2 years. He experiences difficulty recalling names and details from
previous conversations but has remained independent in activities of daily
living. Examination shows 1/3 recall after 5 minutes but is otherwise normal.
Brain MRI demonstrates bilateral hippocampal atrophy. Which of the
following cortical areas are most likely to show reduced metabolism on
fludeoxyglucose positron emission tomography (FDG-PET) scan?
A.
B.
C.
D.
E.
anterior cingulate
anterior temporal
dorsolateral prefrontal
medial parietal
ventrolateral prefrontal
1719
Postreading Test
b 39. A 62-year-old woman with a history of diabetes mellitus and hypertension

is evaluated for sudden-onset headache and left face and upper limb weakness
that began 3 hours ago. A noncontrast CT scan of the head is shown. Which
of the following is the most likely cause of this patients symptoms?
Reprinted with permission from Liebeskind DS, Sanossian N,

Yong WH, et al. CT and MRI early vessel signs reflect clot
composition in acute stroke. Stroke 2011;42(5):1237Y1243.
doi:10.1161/STROKEAHA.110.605576. B 2011 American
Heart Association, Inc. stroke.ahajournals.org/content/42/5/
1237.short.
A.
B.
C.
D.
E.
arteriovenous malformation
cerebral vein occlusion
middle cerebral artery (MCA) thrombosis
subarachnoid hemorrhage
vasculitis
b 40. A 70-year-old man is referred for carotid ultrasonography after his primary
care provider heard a bruit over the left side of the neck. His ultrasound
shows elevated velocities in the 50% to 69% range. The presence of which of
the following ultrasound findings would be more suggestive of this plaque
being unstable and thus more likely to result in artery-to-artery embolism?
A.
B.
C.
D.
E.
1720
concentric thickening of vessel wall (macaroni sign)

elevated Lindegaard ratio
false lumen with bidirectional flow
intraplaque hemorrhage
uniform hyperechogenicity
October 2016

Postreading Self Assessment and CME Test.25

Загружено:

Сведения о документе

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Postreading Self Assessment and CME Test.25

Загружено:

Авторское право:

Доступные форматы

Self-Assessment and CME

The Continuum Postreading Self-Assessment and CME Test is an integral

b 1. The pattern of hyperintensity in the fluid-attenuated inversion recovery

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 2. A 59-year-old man is admitted to the intensive care unit with a subarachnoid

b 3. A 52-year-old man with a history of diabetes mellitus and hypertension is

Reprinted with permission from Liebeskind DS. Imaging the future

anterior cerebral artery thrombosis

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 4. On magnetic resonance spectroscopy, which of the following patterns

absence of a lactate peak

b 5. A 7-year-old girl is seen for headaches. Her headaches are posterior in

Chiari type I malformation

b 6. The spot sign on CT imaging of patients with intracerebral hemorrhage

cavernous malformation as the cause of bleeding

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 7. A 44-year-old man is seen in the emergency department with several days

acute disseminated encephalomyelitis (ADEM)

diffusion-weighted imaging (DWI)

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 9. A 64-year-old woman is evaluated after awakening with right hemiparesis

failure to develop collateral circulation

b 10. Which of the following conditions might result in impaired visualization of

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 11. A 45-year-old man is evaluated for progressive gait difficulties, urinary

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 12. Multiple observational studies have shown a higher prevalence of

b 13. A 43-year-old woman with a known pituitary microadenoma (found

Modified with permission from Gaillard F, Radiopaedia.org,

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 15. A 25-year-old man is evaluated for spells characterized by behavioral arrest

disruption of the blood-brain barrier

b 16. A 33-year-old woman is evaluated for recent headache and pulsatile

compression of the optic nerve sheath

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 17. A 28-year-old woman is seen in clinic after a recent emergency department

focal cortical dysplasia of the superior temporal gyrus

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 18. A 76-year-old woman is evaluated for intermittent memory difficulties over

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 20. A 4-year-old-girl is evaluated for spells of transient unresponsiveness

desmoplastic infantile ganglioglioma

b 21. An 18-year-old man is evaluated for the recent onset of intermittent

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 22. Which of the following imaging characteristics is typical of the classic

absence of the fourth ventricle

b 24. Which of the following imaging characteristics would be most consistent

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

A. cortical laminar necrosis

elevated mean flow velocities in the middle cerebral arteries

Continuum (Minneap Minn) 2016;22(5):17011720

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 27. A 72-year-old man with history of hypertension is evaluated for a 2-year

Copyright American Academy of Neurology. Unauthorized reproduction of this article is prohibited.

b 29. A 20-year-old right-handed man is evaluated for spells characterized by

Reprinted with permission from Cendes F. Neuroimaging in

aberrant axonal sprouting

Continuum (Minneap Minn) 2016;22(5):17011720