Interpretation of Cranial CT

& MRI Masterclass

Dr Catriona Good
Neuroradiology
ESSENTIALS OF NEURORADIOLOGY

Don’t Get Lost In The

Complex Anatomy
 CASES
• SAH
• Trauma • Venous thrombosis
• Brain sepsis • Brain tumour
• Cerebral oedema • Spine
• Pituitary apoplexy
• Encephalitis
• Complex brainstem
lesion
• Hydrocephalus
• Stroke
Subarachnoid Haemorrhage
 CTA
CT Angiography
SAH plus global ischaemia
Treatment of aneurysms: coiling
Acute extradural bleed
Acute on chronic subdural haemorrhage
TRAUMA
Cerebral
Abscess
Cerebral oedema
Venous sinus thrombosis
Venous infarct
Pituitary Apoplexy
Pituitary Apoplexy
 Boy of 15 Admitted in Coma

1) Diagnosis Herpes simplex encephalitis

2) Outcome Complete recovery
 Encephalitis
Herpes simplex ADEM
 Limbic encephalitis

Voltage gated channelopathy anti Ma 2 paraneoplastic

 WERNICK’S ENCEPHALOPATHY
47-year-old woman with a history of alcohol abuse presented with ataxia, changes in
consciousness, and ocular abnormalities.

Zuccoli G et al. AJNR Am J Neuroradiol 2009;30:171-176

©2009 by American Society of Neuroradiology

28 F Pregnant, hyperemesis, sudden onset
ataxia and brain stem Sx 10d ago
28 F Pregnant, hyperemesis, sudden onset ataxia and
brain stem Sx 10d ago
Previous nasopharyngeal ca , prev DXT 8 years ago
Previous nasopharyngeal ca , prev DXT 8 years ago

Post Gd
Incidental pituitary nodule
 HYDROCEPHALUS

• Acute hydrocephalus
• Blocked shunt
 65 year old man with headache and confusion
Diagnosis ?

CT No C MRI T2 MRI T1 No C

Colloid cyst
• STROKE
– Within 6-12 hours CT is often negative. The important
thing is to exclude haemorrhage or other pathology
12 Hours
60 hours
Infarct sup cerebellar a Infarctinferior cerebellar a
T2
FLAI
R

DWI
45y sudden horner
Follow up
Frequent focal fits-right leg

CT reported
as ischaemic
Frequent focal fits-right leg
Malignant tumour
glioblastoma
Gliodel wafers
Gliodel wafers
Butterfly glioma
Brain metastases
Spine metastases
Spine metastases with cord compression
Spinal infection: Discitis
Spinal cord ischaemia