ECNR 4 Athens4
4 Kurs Brain Trauma
4 Kurs Brain Trauma
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Cartes-fiches
Polymicrohyria
Genetic
sekumdary > After 20 gestation week, cmv
like gray matter
Focal cortical dyplasia
Type I dyslamination - Neurons intakt
Type II Neurons defect - better Senn in mri
Entwicklung MRI in Kind T1 and T2
Normal T1 After 1 Year MRI
normal T2 After 2 Year
Alzheimer
Tau Protein intrazellular
amyloid extrazellulär
Five biomarkes makes diagnosis
ADC can Show microstructure - showing widespread changes for AD to normals
Frontotemporale Formen der Degeneration
Behaviour
language (Semantik)
ADC difference
MSA
PSP
ADC high in dorsal putamen in MSA-P und Middle cerebellum peducnle MSA-C
PSP - Dorsal thalamus ADC high
Problems of HIV nowadays?
Chromic disease
dementia HAND
vascular
Sporadic Cjd
variant CJD
Sporadisch DWI in cortex and BG
variant Mad cow - nö cortex, but Hockey stick in thalami dwi
Dissimination in Space ?
DIS Can Be Demonstrated by >= 1 T2 Lesion in at Least 2 of 4 Areas of the CNS: Periventricular Juxtacortical Infratentorial Spinal cord If a subject has a brainstem or spinal cord syndrome, the symptomatic lesions are excluded from the Criteria and do not contribute to lesion count
Dissimination in Time
DIT Can Be Demonstrated by: A new T2 and/or gadolinium-enhancing lesion(s) on follow-up MRI, with reference to a baseline scan, irrespective of the timing of the baseline MR Or 1 gd lesion and 1 not enhancing simultan asymtomatic
Hypoperfusoin leads to ...
Amyloiddeposition - Alzheimer?
minderperfusion
Cortical microinfarkts?
<200 micron
not seen 3T
85% Risk to dementia
Fazekas calssification
Microangiopathie
punctat 1
beginnend confl 2
confl 3
Risk of White matter lesions
Demenz
inability
Death
Medial temporal atrophie staging
Normal
fissura choroidalis 1
kollateral sulcus, temporal horn 2
flatten hippocampus 3
atrophie hippocampus 4
Eye of tiger
Hallervorden Spatz disease
Normal atrophie temporal Lobe?
<75 years score >2 abnormal
>75 years score >3 abnormal
Alzheimer in juengeren Pat
Meist posterior
aelter - temporal
atypische alzheimer - Frontal
DD Alzheimer
Hippocampal sklerosoe
FTLD - Semantik , Asymmetrie
Dementia with Parkinson
Lewy body
psp - mesencepahon 14 mm
msa - hot Cross bun
corticobasal
Presenil Alzheimer wo atrophie
Precuneus
posterior areas
Was macht amyloid inCSF bei Alzheimer
Es geht im Verlauf runter
wenn "gesunder" tiefes amyloid im liquor - predictor?
Inherited dementia
Frontotemporal -50%
alzheimer rar
Alzheimer PET
Amyloid negativ excludes AD
amyloid Lack of spezifity
decresed glc in parietal area posterior cingulat - not where the atrophie is seen first
metabolic preceds structure changes
Where atrophier semantic FTLD?
Left temporal
Lewy Body
amyloid?
l-dopa?
More Amyoid Depositition
l-DOPA decrease posterior part of putamen
PSP glc decrease ?
PET Frontal decreased
Sacroileitis kann was vortaeuschen
L5 oder L4
geht selten über Knie
Mimiker of ischialgie
Femoral nerf compression - l4 or l5 Stops at knee
n cutaneus fem lateralis - neuroma - ventralen Oberschenkel
Obturator nerve Syndrom - pelagisch mass medial inderior Oberschenkel
m piriformis Syndrom - neuroma, Infektion , Chronik Kontraktion , myositis
hamstring Syndrom - infalmationen tendoms
ischiatic bursitis
Instabilität LWS
Dynamic Slip > 3 mm
stativ > 5 mm
angle > 15 degree
vakuum
Sign. Of Fusion After spondylodese?
Also small Bone bridges
pseudaethrosis > modic I After 6 month
lockerung - wenn Saum um metall wenn 1 jähr nach OP
Osteoporotic Frakturen
Therapie
Vertebroplastie
90% schmerzverbesserung
hoehenkorrektur in ersten 3 Wochen moeglich
Vertebral augmentation
Traumatische Frakturen - wenn hinterkante beteiligt, nicht zuviel zement
osteoporoe, weil Schrauben nicht halten
Maligne Tumoren der Nerven peripher
Sekundäres lymphom
perineuroma
Maligne Tumoren der Nerven peripher
Sekundäres lymphom
perineuroma
Reichern bestrahlte Nerven an?
No -aber ödem
Longstanding compressing of nerve root mri?
Wallersche Degeneration macht zwar ödem , an stays hyperintense
Pseudomeningocele
Perhaps in Nerv Root transsection
Cap sign.
Bleeding on the cap in ependymoma
Most Common malignant Bond Tumor spine in children
Ewing sarkoma
