DDx Skull and Brain

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Subarachnoid hemorrhage: Ruptured intracranial hemorrhage
Perimesencephalic venous hemorrhage (diagnosis of exclusion with patients with blood in the pontine cistern and normal cerebral angiography)
Trauma
Parenchymal hematoma
Brain arteriovenous malformation/fistula
Spinal AVM
Cervical Eependymoma
No cause found
Complications of Subarachnoid hemorrhage: hydrocephalus
vasospasm
infarct
rebleeding
diffuse cerebral swelling and cerebral herniation
Acute Bacterial Meningitis: normal (most common finding early)
diffuse brain swelling
meningeal enhancement
ventriculitis (linear enhancement of ependymal lining)
hydrocephalus (more typically communicating)
subdural empyema
sterile collections
focal sepsis within temporal bone, paranasal sinus or skull vault
arterial infarct
venous infarct
cerebritis/cerbral abscess
venous infarct
atrophy encepahalomalacia
Viral encephalitis: Herpes Simplex hemorrhagic necrotizing encephalitis-prediliction limbic system, medial temporal lobes and inferior frontal lobes)
HIV
Sporadic Creutzfeldt Jacob Disease
Variant Creutzfeldt Jacob
Disease
Progressive multifocal leukoencepalopathy PML
Rasmussens Encephalitis
Polio
Acute cerebellitis
Congenital CNS Infection: CMV (targets the developing germinal matrix -produces multiple foci of calcification in a periventricular distribution-other feature microcephaly, deafness choriretinitis and polymicrogyria-lissencephaly, hypoplastic cerebellum and marked ventriculomegaly occur with early in utero infection)

Toxoplasma (foci of calcification more scattered than those seen in CMV-hydrocephalus occurs secondarily to aqueduct stenosis-microcephaly, porencephaly and choriretinitis are other manifestations)
Rubella (deafness cataracts, micropthalmia atrophy parenchymal calcifications)
Herpes Simplex (acute neonatal form -diffuse or focal white matter edema +/- hemorrhage-infection not localized to the limbic system as in older kids and adults-mermingeal enhancement in the acute stage-subsequent atreophy and cystic encephalomalacia)
HIV (diffuse cerebral atrophy. Calcification of the basal ganglia after the first year of life)
Head Injury Extra axial: extradural hemorrhage
subdural hemorrhage
subarachnoid hemorrhage
intraventricular/choroid plexus hemorrhage
skull fracture
csf laek
pneumocephalus
cranial nerve palsy (VII nerve du to temporal bone invovlment)
Head Injury Intra axial: Diffuse axonal injury
Hemorrhagic Contusions
Deep grey matter and brainstem lesions
Hypoxia
Head Injury Secondary Brain Injury: Intracerebral herniation
Diffuse cerebral edema and ischemia
Embolic complications (secondary to arterial damage ie dissection)
Meningitis
Hypoxia
Head Injury Delayed Brain Injury: Atrophy
CSF leak
Arterial pseudoaneurysm (following arterial laceration)
Arteriovenous fistula
Leptomeningeal cyst
Non Accidental Injury: Subdural hematomas
Skull fracture
Cortical contusion / shearing injuries
Cerebral Edema
Hypoxia
Subarachnoid and intraventricular hemorrhages
Subdural Hygromas
Cerebral Laceration
Vascular Injuries
Coexsting non CNS injury (retinal hemorrhages, skeletal #s)
Large Head in Infancy: hydrocephalus
chronic subdural hematoma
neurofibromatosis
mucoplysachiridosis
megaencephaly
Alexander's Disease (leukodystrophy involves the frontal lobes early in its course)
Canacan's Disease (leukodystrophy involves the subcortical arcuate fibres, but often the entire cerebral white matter)
hydranencephaly
Wide Cranial Sutures: RAISED INTRACRANIAL PRESSURE (kids < 10)
Subdural hematoma
Hydrocephalus
Intracranial Tumor

INFILTRATION OF SUTURES
Neuroblastoma
Leukemia
Lymphoma

METABOLIC DISEASE
Ricket's
Hypoparathyroidism
Lead intoxication
Bone dysplasias with defective mineralization

RECOVERY FROM ILLNESS (rapid regrowth of the brain following)
Deprivational Dwarfism
Chronic Ilness
Prematurity
Hypothyroidism
Non Comunicating Hydrocephalus (intraventricular obstruction): LATERAL VENTRICLES
intrinsic tumor (solid or ependymal)
extraventricular tumor (mass effect)

FORAMEN of MUNRO
tumor (colloid cyst, subependymal giant cewll astrocytoma)
ventriculitis (adhesive arachnoiditis)
hemorrhage (fresh clot or delayed adhesive arachnoiditis)
cerebral swelling (subfalcine herniation)

THIRD VENTRICLE
intraventicular tumor
extraventricular tumor (pit adenoma, cranio, arachnoid cyst)

CEREBRAL AQUEDUCT
intraventricular tumor (ependymal seeding)
extraventricular tumor (pineal mesencephalic, tentorial mass lesions)
developmental aqueductal stenosis
ventriculitis
hemorrhage

FOURTH VENTRICLE
intraventricular tumors (ependymoma, mets)
extraventricular tumors (medulloblastoma, mets, hemangioblastoma, large posterior extrinsic masses (meningioma, vestibular schwannoma)
Comunicating Hydrocephalus (extraventricular obstruction): (impaired reabsorbtion by arachnoid granulation accounts for the majority of cases)

SAH
Infectious meningitis
Malignant Meningitis (breast, lung)
Granulomatous meningitis (sarcoid, TB)
Altered venous dynamics (Vein of Galen malformation)
Hydrocephalus (other): External Hydrocephalus
(benign enlargemenr of subarachnoid space seen in some young children. Caused by a disproportionate growth between skull and intracranial contents)

Overproduction Hydrocephalus (choroid plexus papilloma)

Normal Pressure Hydrocephalus
Clinical Syndrome of Memory Loss, gait disturbance and urinary incompeteance. Imaging demonstrates ventricular enlargement disproportionate to the degree of sulcal widening)
Clinical Syndromes Associated with Enlarged Ventricles: Achondroplasia
Soto's Syndrome (cerebral giantism, advanced skeletal maturity)
Acrocephalosyndactly (Aperts and Pfeiffer)
Crouzon Syndrome
Fetal Alcohol Syndrom
Lissencephaly
Pneumocephalus: Trauma
Iatrogenic
Osteoma of the Ethmoid Sinus
Tumor eroding the base of the skull arising in the siuses or nasopharynx
Empty Sella (spontaneous communication between the sella and the spenoid sinus)
Differential Diagnosis of a Solitary Intracerebral Mass: GBM
Mets
Arterial Infarct
Abscess
Demyelination
Hematoma
Encephalitis
Aneurysm
Intracranial Calcification: NORMAL
pineal gland
choroid plexus (atria of lateral ventricles, unusual in 3rd and 4th ventricles)
Dura
Habenular Commisure (C shaped calcification within the tela choroidea of the 3rd ventricle)
Basal Ganglia
Dentate Nuclei
Parasellar ligaments
Arachnoid Granulations

VASCULAR
atherosclerosis
aneurysm
AVM
cavernous angioma
chronic SDH
Old infarct/hemorrhage

TUMORS
meningioma
glioma (<10% of astrocytomas calcify)
Oligodendroglioma 50% calcify
Craniopharyngioma
Ependymoma
Choroma and Chondrosarcoma
DNET
Central Neurocytoma
Mets (adenocarcinoma (breast, GIT))
Pineal Tumors (teratoma germinoma)
Lipoma (crescentic calcification in the midline)

INFECTION
TORCH
Cysticercosis periventricular, cisternal and corticomedullary nodules)
TB (basal cisterns, ventricle and parenchyma)

BASAL GANGLIA CALCIFICATIONS
normal
endochrine
metabolic (mitochondrial disorders, Fahrs)
Infection
Toxic (hypoxia, carbon monoxide, lead)
Chemotherapy/Radiation

NEUROCUTANEOUS
Sturge Weber (dystrophic calcification of the cerebral cortex)
TS (periventricula or parenchymal)
Neurofibromatosis (choroid plexus, premature, excessive), subependymal and basal ganglia, neoplastic)
Enhancement of the Meninges on CT and MRI: LEPTOMININGEAL
Infection (TB, bacterial, fungal, syphilis, viral Lymes Disease)
Tumor (mets, GBM, leukemia, lymphoma, germinoma, pinealblastoma, ependymoma, medulloblastoma LCH)

DURAL
Infection (skull base osteomyelitis)
TRumor (meningioma, mets, lymphoma)
Postoperative (craniotomy, shunt)
Sarcoid
RA
Enhancement of the Ependyma and Sub Arachnoid Space on CT and MRI: EPENDYMA
infection
tumor
Sarcoid
Enlarged ependymal veins
Inflammatory

Sub Arachnoid Space
meningitis
neoplasm
post angiography
Basal Ganglia Bilateral Abnormalities: Corpus Striatum +Caudate nucleus and Putamen

NORMAL
age related change
perivascular spaces

VASCULAR
Lacunar Infarcts
Hypoxia
Venous Infarction

NEURODEGENERATIVE DISEASE
Parkinson's
Huntington's

Other Extrapyramidal Disorders (multisystem atrophy, supranuclear palsy)

TOXIC
Exogenous (methanol, cyanide, carbon monoxide)
Endogenous
Kernicterus (bilirubin encepalopathy)

Acquired Metabolic Disease
Hypoglycemia
Osmotic Myelinolysis
Hemolytic Uremic Syndrome

Inherited Metabolic Disease
Wilsons
Mitochondrial cytopathies
Amino Acid Disorders
Lipidoses
Hallevorden Spatz

OTHERS
basal ganglia calcifications
NF I
Microabscesses cryptococcus, toxoplasmosis
ADEM
Hyperechoic Lesions in the Basal Ganglia of Neonates and Infants: Congenital infections
Asphyxia
Hypoxia
Cardiac Disease (particularlly hypoplastic L haert syndrome)
Chromosomal Disorders
Feta
alcohol Drug Exposure
Twin Twin transfusion
Idiopathic
Thalamus Bilateral Abnormalities: VASCULAR
lacunar infartcs
arterial infarcts
venous infarcts
severe anoxia

INFECTION
variant CJD
Japenese Encephalitis

METABOLIC
Carbon Monoxide Poisening
Wernicke's Encepalopathy (thiamine deficiency, mesial thalamic nuclei, mamillary bodies mid brain and floor of the 3rd venticle show increased T2W signal
Inherited Metabolic Disease
Inherited Metabolic Disease (best seen on T2W images) Dysmyelination (leukodystrophies): Enzyme deficiencies prevent the normal formation of maintenace of myeli.They are disorders of children and presenr with variable mental retardation.

LYSOSOMAL DISORDERS
Metachromatic Leukodystrophy
Krabbe Leukodystrophy

PEROXISOMAL DISORDERS
Adrenoleukodystrophy (ALD)
Zellwegers (cerebrohepatorenal) Syndrome

MITOCHONDRIAL DYSFUCTION
Leighs Disease
MELAS (mitochondrial myopathy, encepalopathy, lactic acidosis and stroke like episodes)
MERFF (myoclonus epilepsy with ragged red fibres)

AMINO ACID and ORGANIC ACID METABOLIC DISODERS
Canavan's Disease
Maple Syrup Urine Disease

OTHER
Pelizaeus-Merzbacher Disease
Alexander's Disease
Differential Diagnosis of Common Myelination Leukosdystrophies Lack Proper Myelin: L= Leighs
Disaese
A=ALD, Alexander's
C=Canavans
K=Krabbe
P=Pelizaeus-Merzbacher
M=Metachromatic Leukodystrophy
Cerebral Atrophy Diffuse: normal aging
excessive alcohol intake
severe head injury
MS
cerebrovascular disease
Drugs (corticosteroids)
encephalitis/meningitis
radiation and chemotherapy
Cerebral Atrophy Focal: Infarct
hemorrhage
encephalitis/meningitis
trauma
alzheimers disease (changes in the mesialtemporal lobes may be more pronounced)
Frontotemporal Dementia
Parkinson's (diffuse atrophy + atrophy of the substantia nigra
Progressive Supranuclear palsy (atrophy of the midbrain (tectum) globis pallidus and frontal lobes)
Pick's (severe frontal and temporal atrophy)
Huntington's Disease Focal atrophy of the caudate nucleus)
Diffuse Cerebellar Atrophy: normal aging
excessive alcohol intake
paraneoplastic (oat cell carcinoma)
Ataxia telangiectasia (olivopontocerebellar degeneration)
Drugs (phenytoin)
encephalitis/meningitis
radiation
Gluten Sensitivity
Friedrich's Ataxia
Disorders of Neuronal Migration: Agyria Pachgyria (poorly formed gyri and sulci

Polymicrogyria may coexist with pachygyria

Lissencephaly = extreme cases with a small brain
Complete lissencephaly = agyria

Type I Lissencephaly
small brain with few gyri
smooth thicked 4 layer cortex (resembles cortex of a 13 w fetus)
shallow vertical sylvian fissures (figure of eight configuration)

Type II Lisencephaly (Walker-Warberg Syndrome)
smoooth cortex, cerebellar hypoplasia and vermian aplasia, hydrocephalus
Disorders of Neuronal Migration Polymicrogyria: The neurons reach the cortex but are abnormally distributed. Macroscopically the surface of the brain is covered in small bumps. Localized abnormalities more common than than generalized and often involve arterial territories especially MCA. Most common loaction is the sylvian fissure.
Disorders of Neuronal Migration Schizencephaly: Clefts which extend through the full cerebral mantle from the ventricle to the sab arachnoid space. Lined by heterotopic grey matter and microgyrias
Disorders of Neuronal Migration Heterotopic Grey Matter: Collections of neurons in subependymal location ie at the site of germinal matrix or arrested within the white matter on the way to the cortex
Intracranial Manifestations of Well Known Neurocutaneous Disorders Neurofibromatosis I: Optic glioma
non-optic glioma (tectum brainstem)
plexiform neurofibroma
vascular abnormalities
skull (spenoid wing dysplasia, calvarial defects and dural ectasia)
orbit (lisch nodules, retinal phakomas, buphthalamos and pulsatile exopthalamus, harlequin orbit
Intracranial Manifestations of Well Known Neurocutaneous Disorders Neurofibromatosis II: cranial nerve schannomas
Meningiomas
Non-neoplastic choroid plexus lesion
ependymomas
Intracranial Manifestations of Well Known Neurocutaneous Disorders Tuberous sclerosis: cortical tubers
subependymal nodules
giant cell astrocytoma
white matter lesions (disorganized collection of dysplastic cells)
orbit (retinal phakoma)
Vascular abnormalities *aneurysm and vessel stenosis)
Intracranial Manifestations of Well Known Neurocutaneous Disorders Sturge Weber Syndrome: cerebral atrophy (compensatory thickening of the skull
cortical calcification (tram track gyriform calcification underlying pial angioma
surface enhancement ( correspond to embryonal pial angioma that persist in SWS because of hypoplasia of the cortical veins. Bilateral in 20%.
Enlarged Choroid Plexus
Enlarged medullary/subependymal veims (centripital shunting often by anomalous venous structure in response to an inadequate cortical venous system)
Orbit bupthalamos, sclera/choroidal angioma, glaucoma
Intracranial Manifestations of Well Known Neurocutaneous Disorders Von Hiippel Lindau: Hemangioblastoma
Orbit (retinal angioma, micropthalmia +/- dystrophic calcification)
Non -CNS (visceral cyst pheochromocytoma, renal cell carcinoma)
Intracranial Manifestations of Well Known Neurocutaneous Disorders Osler-Weber-Rendu (Hereditary Hemorrhagic Telangiectasia): cerebral abscess (caused by septic emboli passing though pulmonary arteriovenous malformation
Embolic Infarcyts
Vascular Abnormalities (telangeictasia,cavernoma, AVM. AVF, aneurysm and epistaxis)
Non-CNS (mucutaneous and visceral telangiectasia)
Supratentorial Lesions in Children: hemispheric astrocytoma
craniopharyngioma
optic pathway glioma
giant cell subependymal astrocytoma
germ cell tumore
PNET
DNET
Ganglioglioma (peripheral cystic tumor with mural nodule +/- calcification)
choroid plexus papilloma
Ependymoma (often in the frontal lobe adjacent to the frontal horn but not within the ventricular system)
Infratentorial Lesions in Children (comprise 50% of pediatric cerebral tumors): Cerebellar Astrocytoma (25% of posterior fossa tumors Vermis 50%, hemispheres 20%, both sides 30%)

Medulloblastoma (30-40% of posterior fossa tumors, 80% in the vermis, 30% extend into the brain stem)

Ependymoma (mostly in the floor of the 4th ventricle 8-15% 0f posterior fossa tumors, tumor extension through the foramona of Magendie(foramen magnum)or Luschka CP angle))

Brainstem Glioma 20-30% of posterior fossa tumors

(4 subgroups i)medullary ii) pontine (most common) iii) mesencephalic iv) those associated with NF I
Small Pituatary Fossa: Normal Variant
Dystrophia Myotonica (starts early adult life, ctaracts baldness, testicular atrophy, thick skull large frontal sinus)
Radiotherapy as a child
Hypopituatarism
Expanded Pituatary Fossa: Size Normal Range height 6.5-11, length 9-16mm, breadth 9-19mm)
Elevation destruction of clinoid process
Loss of Lamina Dura
Para/intasella mass
Raised ICP (due to dilated 3rd ventricle)
Nelson Syndrome (post adrenolectomy for Cushings Syndrome)
J shapes sella: Flatterened tuberculum sella with prominent sulcus chiasmaticus

Normal
Otic chiasm glioma
NF
Achondroplasia
Mucopolysachiridoses
Chronic Hydrocephalus
Intrasella Mass: NEOPLASTIC
Pit Microadenoma
Pit Macroadenoma
Meningioma
Cranio
Chordoma
Pit met (braet most common)

NON NEOPLASTIC
Pit Cyst
Pit hyperplasia
Internal carotid aneurysm
Ectatic carotid artery
Rathke Cleft Cyst
Lymphocytic hypophysitis
LCH (more common infundibulum)
Pit abscess (rare)
Infundibular Mass: NEOPLASTIC
germinoma
lymphoma
leukemia
glioma
mets (breast hematogenous medulloblastoma leptomeningeal)

NON NEOPLASTIC
Sarcoid
Lymphocytic Hypophysitis (lymphocytic infiltration of the anterior pit. occuring preganacy/post partum)
LCH (with loss of pit bright spot)
Suprasellar Mass: NEOPLASTIC
Pit Macroadenoma
Meningioma
Cranio
Chiasmatic Glioma
Infundibular Tumor
Germinoma
Hypothalamic Hamartoma

NON NEOPLASTIC
Aneurysm or ectatic carotid artery
arachnoid cyst
Epidermoid
Dermoid (occurs midline fat and calcification
Rathkes Cleft Cyst
Lymphocytic Hypophysitis Sarcoidosis
LCH
Cavernus Sinus/Parasellar Mass: NEOPLASTIC
Schwannoma (trigemial can extent through foramen ovale)
Meningioma
Pit Adenoma
Met
Lymphoma
Invasion by skull base tumor (Chordoma)
Nasopharygeal Tumor

NON NEOPLASTIC
Aneurysm or ectatic carotid
Carotid Cavernous fistula
Invasive sinusitis
Dermoid/epidermoid
Sarcoid
Lymphocytic hypophysitis
Tolosa Hunt Syndrome opthalmaplegia casued by granulomatous infiltration of the cavernous sinus ad superior orbital fissue (steriod reponsive))
Pineal Region Mass Pineal Gland: Benign Cyst
Germinoma (most common)
Teratoma (2nd most common)
Parenchymal cell tumors (present later in life Pineocytoma tend to be slow growing, Pinealoblastoma usually larger more heterogenous with greater propensity for local invasion and CNS dissemination)
Pineal Region Mass Posterior Brainstem: Glioma (tectal tumor aqueductal stenosis)
Mets
Demyelination
Infarct
Hemorrhagic contusion
Cavernoma
Pineal Region Mass Posterior 3rd Ventricle: Glioma
Mets
Choroid Plexus Papilloma
Pineal Region Mass Perimesephalic Cistern: Arachnoid cyst
Dermoid Lipoma
Meningioma
Mets
AVM
Aneurysn PCA
Hyperdense Choroid Plexus on CT: Calcification
Hemorrhage
Hemangioma
Choroid Plexus Neoplasm
Aortic Obstruction in the newborn
Intraventricular Masses in Children: LATERAL VENTRICLES
glioma
PNET
Choroid plexus papilloma
choroid plexus cyst
Choroid plexus enlargement (Sturge Weber, NF)
Subependymoma
Meningioma
AVM
Subependymal heterotopia Metastatic seading

FORAMEN OF MUNRO
subependymal giant cell astrocytoma

THIRD VENTRICLE
cranio
glioma
LCH
Germinoma
Choroid plexus papilloma
Metastatic Seeding

FOURTH VENTRICLE
Medullablastoma
Ependymoma
Choroid plexus papilloma
exophytic brain stem glioma
Intraventricular Masses in Adults: LATERAL VETRICLE
GBM
Oligodendroglioma
Central Neurocytoma
Lymphoma
Mets
Subependymoma
Memingioma
Choroid Plexus cyst/calcification
Arteriovenous malformation
subependymal heterotopia

FORAMEN of MUNRO
Colloid Cyst
Subependymal giant cell astrocytoma

THIRD VENTRICLE
Cranio
Germonoma
Met
Subependymoma
Sarcoid

FOURTH VENTRICLE
mets
Subependymoma
Choroid plexus papilloma
Inflammatory cyst (cysticercosis)
hemangioblastoma
CP Angle Masses: Vestibular Schwannoma
Meningioma
Epidermoid
Trigeminal schwannoma
aneurysm
mets
skull based tumors
skull based infection (Gradenigo's syndrome (osteomyelitis of the petrous apex) and malignant otitis externa
Internal Auditory Canal Abnormality: NEOPLSTIC vestibular nerve Schwannoma
Meningioma
Facial nerve schannoma (arises geniculate ganglion)
Mets
Hemangioma
Lipoma

NON NEOPLASTIC
Bell's Palsey
Postoperative
Sarcoid
LCH
Middle Ear Mass: INFLAMMATORY
Acquired cholesteatoma (a slowly expanding mas of epithelial debris originating in the middle ear
Acute otitis media
malignant otitis externa
cholesterol granuloma (non-specific chronic inflammation of the middle ear and mastoid (ossicles may be eroded))

NEOPLASTIC
glomus tympanicum
glomus jugulare
facial nerve schwannoma
temporal bone mass

Vascular aberrant internal carotid artery
dehiscent jugular bulb
serous otitis media (sterile fluid fills the middle ear, middle ear is typically intact however ossicles may be eroded)
Middle Era effusion ( obstruction of the Eustacian tube nasopharyngeal carcinoma)
Tympanosclerosis (deposits of fibrotic often calcified tissue in the middlew ear mass aroud the ossicular chain ankylosising
Temporal Bone mass: NEOPLASTIC
glomus mningioma mets myeloma
'lymphoma nasopharyngeal carcinoma
carcinoma of the external auditory canal
Ca Parotid gland
rhabdomyosarcoma (most common soft tissue sarcoma in children)
chondrosarcoma (centered on petroclival suture)
chordoma

NON NEOPLASTIC
cholesteatoma
cholesterol granuloma
apical petrositis
aneurysm
LCH
Temporal Bone Sclerosis: Otosclerosis
Paget's Disease
Fibrous Dysplasia
Osteopetrosis
Meningioma
Pulsatile Tinnitis: ANATOMOICAL VARIANTS
Large/dehiscent jugular bulb
Intratympanic course of the ICA
Persistent stapedial artery

VASCULAR
Dural Arteriovenous fistula
Aneurysm of the petrous carotid
Venous thrombosis
Arterial Stenosis

NEOPLASTIC
paraganglioma (glomus jugulare tympanicum)
Jugular Foramen Mass: NEOPLASTIC
glomus jugulare
schwannoma
direct invasion NPC
mets
meningioma
chondrosarcoma
LCH
lymphoma

NON NEOPLASTIC
Normal jugular bulb
Venous thrombosis
skull base osteomyelitis
Foramen Mgnum Mass: INTRINSIC CERVICOMEDULLARY LESION
glioma
ependymoma
demyelination
syrinx

ANTERIOR INTRADURAL
aneurysm
meningioma
schwannoma

POSTERIOR INTRADURAL
chiari malformation
secondary tonsillar descent
ependymoma
medulloblastoma

EXTRADURAL
inflammatory arthropathies RA
Skull based tumor chordoma, met, myeloma glomus
Osteomyelitis
Diffuse Skull Based Abnormality: NEOPLASTIC
mets (breast bronchus, prostate) 4 clinical syndromes i) orbital syndrome ii)parasellar and middle fossa syndrome
iii) jugular foramen syndrome
iv) occipital condyle syndrome)
myeloma'NPC
lymphoma
meningioma
rhabdomyosarcoma

NON NEOPLASTIC
fibrous dysplasia
Pagets Disease
Osteomyelitis
LCH
renal osteodystrophy
hemaglobinopathy
Skull vault Lucency with No Surrounding Sclerosis: NORMAL
parietal foramina
venous lakes and vascular channels
pachonian granulations
Frontal temporal, occipital lucencies
prominent digital markings
fontanelles

NEOPLASTIC ADULT
Myeloma
Mets
Pagets sarcoma

NEOPLASTIC CHILDREN
mets
LCH

TRAUMATIC
leptomeningeal cyst
Burr hole

METABOLIC HPT
osteoporosis

INFECTIVE
pyogenic
TB
hydatid
syphilis (moth eaten)

VASCULAR
hemangioma
sinus pericranii

Others osteoporosis circumscripta neurofibroma
intradiploic arachnoid cyst
Skull Vault Lecency with Sclerosis: Fibrous Dysplasia

DEVELOPMENTAL
epidermoid
encephaloce3le/meningocele

NEOPLASTIC
hemangioma
LCH

INFECTIVE
chronic osteomyelitis
frontal sinus mucocele
Generalized Incraese in Vault Density: Pagets Disease
sclerotic mets (breast prostate)
fibrous dysplasia
myelofibrosis
renal osteodystrophy
fluorosis
acromegaly
phenytoin
chronic hemolytic anemia
sclerosing bone dysplasias (osteopetrosis, pyknodysostosis, Pyles Disaese (metaphyseal splaying of the long bones))
Localized Increase in Skull Vault Density: Within bone
tumor (osteoma, treated lytic mets, treated brown's tumor)
paget's dx
hyperostosis frontalis interna

Adjacent to bone
meningioma
clacified cephalohematoma
hair braids
calcified sebaceous cyst
fibrous dysplasia
depressed boe fragment
Thick Skull: Generalized
normal variant
phenytoin
microcephaly
shunted hydrocephalus
acromegaly
extramedullary hematopoiesis

Focal
normal variant
Paget's
hyperostosis frontalis interna
fibrous dysplasia
meningioma osteoma
mets
Thin Skull: Genralized
HPT
Osteogenesis Imperfecta
Rickets
Raised ICP
Lacunar skull ((luckenschadel) bone dysplasia of the membranous skull. Deep indentations or pits in the frontal or parietal regions that may traverse the full thickness of the skull. The defects are seperated by thin rims of bone that have sharp edges creating a 'soap bubble' appearance)
Cushings Disease

Focal
Normal variants
Osteoporosis Circumscripta
Arachnoid cyst
slow growing cortical tumor
large intracranial cyst (arachnoid and porencephalic cysts)
Multiple Wormian Bones (intrasutural ossicles common in infancy) PORK CHOPS I: pyknodysostosis
osteogenesi imperfecta
rickets
kinky hair (menkes) syndrome
cleidocranial dysostosishypophosphatasia/hypothyroidism
Otopalatodigital syndrome
primary acroosteolysis (hadju/cheney)
Pachydermoperiosttitis
Progeria
Syndrome of Down
Idiopathic
Primary Craniosynostosis: Sagital synostosis=scaphocephaly (elongated boat shape)

Unilateral coronal synostosis
Bilateral coronal synostosis
Metopic synostosis
Unilateral lamdoid synostosis
Bilateral lamdoid synostosisCloverleaf Skull (trilobed skull) kleeblattscheidel
Secondary Craniosynostosis: Metabolic rickets, hypeparathyroidism, hypophosphotasia
inborn errors of metabolism
hematologicla disease
brain malformation (holoprosencephaly, microcephaly
Iatrogenic (shunted hydrocephalus)
Bsilar Invagination: primary developmental/segmental abnormality (Klippel Feil syndrome)
Rickets / Osteomalacia
Paget's Dx
Fibrous Dysplasia
Osteogenesis imperfecta
Platybasia flattened skull base: Rickets / Osteomalacia
Paget's Dx
Fibrous Dysplasia
Osteogenesis imperfecta
HPT
'HAIR ON END' Skull Vault: hemolytic anemia
sickle cell anemia
thalassaemia
others

Neoplastic
hemangioma
meningioma
mets

Others
cyanotic heart disease
iron deficiency anemia
Signal Void on T2W MRI: Normal
normal arterial and venous flow
densly packed bone (temporal bone is composed of air cells dense bone-emits no signal CSF filled membranous labyrinth is highlighted)
dural calcification (dense calcificaion of the falx may present as an area of T2 void)
AIR
CSF flow

Pathological
anuerysms
AVM
Acute hemorrhage (deoxyhemaglobin)
Chronic hemorrhage (hemosiderin deposition)
High Signal on T1W MRI: Normal
posterior lobe of the pituitary
mnoving structures(dural venous sinuses, moving CSF may have the same effect)
Ossification of the falx
Cacification of the basal ganglia
Rathkes clet cyst
Fat

Pathalogical
hemorrhage (methemoglobin in 'subacute' hematomas
thrombus
fat (lipoma, dermoids)
Proteinaceous fluid craniopharyngioma, colloid cyst
melanin (melanoma, neurocutaneous melanosis)
heavy metals manganese in total parenteral nutrition)

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Deck Info

Number of cards 78