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Topics in Brain

  • Anatomy

    • Cisterns

      • Premedullary cistern

      • Prepontine cistern

      • Cerebellopontine cistern

      • Cisterna magna

      • Superior cerebellar cistern

      • Interpeduncular cistern

      • Ambient cistern

      • Quadrigeminal cistern

      • Suprasellar cistern

    • Surface Anatomy

      • Frontal lobe

        • Superior

        • Middle

        • Inferior

          • Pars orbitalis

          • Pars triangularis (44) Broca

          • Pars opercularis (45) Broca

        • Precentral gyrus

      • Parietal lobe

        • Superior lobule

        • Intraparietal sulcus

        • Inferior lobule

          • Supramarginal

          • Arcuate

        • Postcentral gyrus

      • Midsagital

        • Corpus callosum

        • Callosal sulcus pars marginalis

        • Cingulate gyrus

        • Cingulate sulcus

        • Superior gyrus

        • Paracentral lobule

        • Parietoocciptial sulcus

        • Calcarine sulcus

        • H-shaped subparietal sulcus

        • Precuneus

        • Cuneus

        • Lingual

  • Congenital and malformations

    • Neurophakomatoses

      • NF1

        • Findings: Cafe-au-lait spots, Lisch nodules in the iris, plexiform neurofibromas, axillary/ingiunal freckling, bone dysplasias, pseudoarthroses, optic pathway gliomas

        • Astrocytomas may arise in the basal ganglia, optic radiations, cerebellar gray or white matter, or brain stem at the sites of high intensity foci on T2WI.

      • NF2

        • Bilateral CN VIII schwannomas.

        • CN V is the second most common site of schwannomas

        • Ependymomas

        • Meningiomas

      • TS

        • Periventricular subependymal nodules, cortical and subcortical peripheral tubers, white matter hamartomas, subependymal giant cell astrocytomas (rare)

        • renal cysts and RCC, adenoma sebaceum, retinal hamartomas, shagreen patches, ungal fibromas, rhabdomyomas of the heart, angiomyoliomas of the kidney, cystic skeletal lesions

      • SW

        • Port-Wine stain

        • Leptomeningeal capillary-venous angiomatosis

      • vHL

        • Hemangioblastomas

        • Renal cysts, RCC

      • Meningiomatosis

      • Neurocutaneous melanosis

        • Melanotic thickening of the meninges (high signal intensity on T1WI)

      • Hereditary hemorrhagic telangiectasia






        Cafe-au-lait spots, NF



        Lisch nodules

        Retinal hamartomas



        Optic and other gliomas, BO in basal ganglia

        Vestibular schwannoma, meningioma

        Tubers, Nodules, SGSA



        NF, dural ectasia

        Schwannomas, Meningiomas, Ependymomas



        Coarctation of aorta



        Renal artery stenosis

        AML, renal cysts, RCC

        Renal cysts, RCC

  • Infection

    • Epidural abscess is usually dorsal to the spinal cord due to anatomy of the venous plexus, but can be anterior due to diskitis

    • Meningitis

      • Basal - TB

      • Leptomeningitis - bacterial infection

      • Pachymeningitis

        • Intracranial hypotension

        • Mets to dura

        • Sarcoid

        • Infection less likely

    • Pyocephalus

      • Rupture of abscess into ventricles

    • Toxoplasmosis

      • Predilection for basal ganglia

      • Edema is out of proportion to the lesion size

      • Target sign on T2 - dark, bright, dark

    • AIDS

      • Basal ganglia calcifications

    • Listeria

      • Mesenrhombencephalitis

  • Demyelinating conditions

    • ADEM lesions are synchronus, MS lesions can be in different stages

    • MS

      • Diffusion restriction indicates that lesion is acute

      • Enhancing lesions are subacute

      • Incomplete ring sign

  • Hydrocephalus

    • Terminology

      • Obstructive

        • Non-communicating

        • Communicating

      • Non-obstructive

        • Ex vacuo

  • Brain Herniations

    • (1) Cingulate herniation under the falx cerebri,

    • (2) Downward transtentorial (central) herniation,

    • (3) Uncal herniation over the edge of the tentorium, or

    • (4) Cerebellar tonsillar herniation into the foramen magnum.

    • Coma and ultimately death result when (2), (3), or (4) produces brain stem compression.

  • Vascular malformations and anomalies

    • Developmental venous anomaly

      • Old term: venous angioma

      • May co-exist with cavernoma

    • Cavernoma

      • Old term: cavernous angioma

    • Capillary telangiectasia

    • Pial AVM

      • Supplied by internal carotid or vertebral circulation

    • Dural AVM

      • Supplied by external carotid

    • AV fistula

      • Drains into dural venous sinus

    • Aneurysm

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