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26 Cards in this Set
- Front
- Back
Genetic & Environmental
Identical Twins Nonaffected Twin Has 30% Chance MS |
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Undersurface CC- Then Extends to Upper Aspect CC |
Posterior Fossa-Flair May Be Not Best Best |
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T1 later disease Axonal Destruction Volume of T1 Lesions Correlate With Degree of Disability |
Perivenular Distribution SWI |
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Cortical Lesions More Common Than Previously Known! |
DIR Double Inversion Recovery PD T1 Inversion Recovery BEST to See Cortical Lesions! |
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Lesion Medial Longitudinal Fasciculus Internuclear Ophthaloplegia Unable to ADDUCT Right Eye |
PosteroLateral Medulla MS Better Seen on T2 Than Flair |
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Periaqueductal Lesion Seen Better T1 IR Than on T2 Wt'd |
Regular T2 Wt'd Window Not See Lesion Change Window- Lesion Right Root Entry Zone Better Seen! |
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McDonald Criteria 2010 DIS Dissemination in Space |
McDonald Criteria 2010 DIT Dissemination in Time |
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Myelin Breakdown Products-- Some Lesions Bright on Precontrast T1 Do Not Call Enhancement! |
How Long Lesions Enhance? Depends on Size- 1 week to 100 weeks- Larger lesions enhance longer |
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Longer You Wait After Injection, Brighter is Contrast Enhancement Seen! 3, 6, 9, 12 minutes |
Acute Plaques May Show Restricted Diffusion! But Not as much as infarction. |
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Tumefactive MS No Enhancement Restricted Diffusion in Rim! |
Incomplete Ring of Enhancement Spares Portion of Wall of Plaque |
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Multifocal Demyelination (Marburg Variant) |
Restricted Diffusion Periphery of lesion -not abscess -not embolic |
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Balo's Concentric Sclerosis Onion Skin Appearance |
Mag Transfer Maximize Difference Between Normal Brain and Plaques |
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Volumetric 3D Flair Cube Obl Sag Obl Axial Along Optic Nerve Lesion Orbit Apex |
Optic Neuritis Top Acute Bottom Resolved |
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Optic Neuritis ?Risk of MS 0 Brain Lesions=25% Risk of MS 1-2 Brain Lesions=65% >3 Brain Lesions=78% |
MS Cord 2D MERGE Look at T2 Also Axial and Sagittal |
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Devic Syndrome NMO Benefits Aggressive Steroid/Plasmapheresis 76% Sensitive |
Devic Long Segment Cord |
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Overlap Imaging ADEM and MS |
ADEM "Monophasic" But May Be Long Phase--May See new lesions one to six months |
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With Triple Therapy Longer Survival |
But With IRIS, Enhancement Much More Common |
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PML- Demyelinating Disease Peripheral Restricted Diffusion (Demyelinating Sign) |
IRIS Lot Edema and Stippled Enhancement
IRIS Also Seen With Cryptococcal Infection |
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LYME Can do anything MS can do, including optic neuritis MUST Alsway do Lyme Titers in suspected MS if clinical history of MS in question! |
MS Should Not Enhance Cranial Nerves Lyme Does #1 CNVII |
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SUSAC RetinocochleacerebralMicroangiopathy
Misdx as MS |
SUSAC Misdx as MS neg, lesion, then resolved Not Enhance |
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Susac Affect CC But Spares the Undersurface of CC -Vasculits Not Demyelinating Disease |
If See Infarcts and Hemorrhage--- Think Vasculitis!!!! |
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Vasculits Patchy- But Nonspecific |
Wegener's Disease Fulminant Whtie matter Enhancement Nasal Septum Involvement |
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Wegener's Disease Enhancement Follows Vessels MS Rounded Enhancement |
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Trident Shape in Pons May or May Not Spare Corticospinal Tracts
Watershed Areas |
Sem Neurol. 2011 Numerous Etiology for PRES- may be easier to list things not associated with PRES |
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Sarcoid- Parenchymal Signal Hyperintensity Also Enhancement along Vessels and Stippled |
Sarcoid May Confuse This Case With MS |