HX: Chronic headache & vertigo , sizure.
Findings:
Axial & sagital T1WI demonstrate a small high
signal right CPA lesion
The lesion is dark on FLAIR fat sat indicating fatty nature
of the lesion.
DX: Lipoma of right CPA.
Top DD
-White epidermoid cyst
-Ruptured dermoid cyst.
-Acoustic schwannoma , hemorrhagic.
HX: Sudden severe headache + nausea & vomiting
Findings:
Axial FLAIR : High signal intensity within the cerebral
Representing SAH)) sulci
Axial T2WI: A small rounded flow void adjacent to the
circle of willis (consistent with the aneurysm)
DX:SAH due to ruptured aneurysm (Right ICA )
Discussion :
Conventional MRI with FLAIR sequence has high
sensitivity and is a reliable imaging technique for acute
SAH, but detection of abnormal increased signal intensity
within the cortical sulci on FLAIR images is nonspecific in
terms of differentiating subarachnoid space diseases related
to blood , inflammation or tumor.
Contrast enhanced MRI and MRA should be done at next
steps.
HX: headache & visual loss following trauma 6 months age
Findings:
Axial T1WI :A hyperintense fat containing mass at
suprasellar & right parasellar region.
Fat droplets are present in subrarachnoid space & in sylvian
fissures.
Axial FLAIR: The lesion is dark on FLAIR fat sat as
opposed to increased signal intensity on T2WI.
DX: Ruptured dermoid cyst
Discussion:
Intracranial dermoids are congenital inclusion cysts most
often in sellar/ parasellar/ frontonasal region. Rupture can
cause chemical meningitis & significant morbidity /
mortality.
HX: Headache, blurred vision & diplopia as well as vertigo
& ataxia for 3 days.
Findings: Increased signal intensity within the superior
sagital ,both transverse & sigmoid sinuses & possibly in
straight sinus.
On MIP images the superior sagital ,transverse
& sigmoid sinuses on both sides can not be seen.
Cortical veins are prominent.
DX: Venous sinus thrombosis in superior sagital, transverse
& sigmoid sinuses.
Discussion:
MRI in combination with MR venography is virtually
always the imaging tool of choice for diagnosis and often for
follow-up of venous sinus thrombosis.
The MR findings relate directly to the imaging of thrombus
within the dural sinuses and the secondary parenchymal
changes that occur as a result of the venous outflow
obstruction.
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