Neuroradiology Teaching Files

 

Author of this site: Gavin Udstuen MD, Assistant Professor of Neuroradiology, Medical Director of Westchester Hospital Outpatient Imaging Center, University of Cincinnati Physicians, UC Health, University of Cincinnati.

These cases are geared toward radiologists and trainees. They may be helpful in preparation for examinations or for tailoring of knowledge and interpretive skills. The images and discussions contain features and terminology that are not targeted to those without medical background and training.

Last update: 3-21-17. Please note that cases 1-150 contain some "old school" imaging- no FLAIR sequence, conventional arteriograms in cases that now get CTA, inclusion of PDWI imaging, etc. obtained prior to 2000. Most of the cases after 150 are circa 2010 or newer.

These cases are limited to the pertinent images, presented in quiz mode below. Please click on a case and think about the findings and diagnosis, then click at the bottom for the answer and brief discussion. The cases are also organized by category for more targeted review.   
 

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120
121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160
161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180
181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200
201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220
221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240
241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260
261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280
281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300
301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320
321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340
341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360
361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380
381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400
401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420
421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440
441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460
461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480
481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500
501 502 503 504 505 506 507 508 509 510 511 512 513 514 515 516 517 518 519 520
521 522 523 524 525 526 527 528 529 530 531 532 533 534 535 536 537 538 539 540
541 542 543 544 545 546 547 548 549 550 551 552 553 554 555 556 557 558 559 560
561 562 563 564 565 566 567 568 569 570 571 572 573 574 575 576 577 578 579 580

 

Congenital
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120

 
Infection/Demyelinating/Inflammatory
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120

 
Neoplasm
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 79
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100
101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120
121 122 122 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140
141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160
161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180

 
Vascular/Ischemic
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100

 
Degenerative
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

 
Metabolic/Other
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40

 
Trauma
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40
41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60
61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80




Cases above listed by diagnosis: 

  -Vascular
            -ACA aneurysm
            -ruptured ACOM aneurysm with corpus callosum hematoma
            -Azygous ACA
            -Delayed L MCA aneurysm rupture
            -L ICA aneurysm, initial neg angio
            -L PCOM w active extrav
            -SDH with PCOM aneurysm
            -IVH with PCOM aneurysm
            -Giant petrous-cavernous aneurysm
            -Basilar aneurysm with fenestration
            -Basilar aneurysm- coiled
            -Basilar aneurysms- complex
            -Basilar Aneurysm- Ruptured
            -Basilar artery thrombosis
            -Pericallosal aneurysm
            -Thrombosed PTA Aneurysm
            -Mycotic aneurysm
            -Mycotic aneurysm2
            -Posttraumatic ACA pseudoaneurysm
            -Internal maxillary pseudoaneurysm
            -Dissecting VB aneurysm
            -PICA aneurysm
            -CCF
            -Direct CCF
            -Dural AV fistula- transvenous coil
            -Dural AV fistula- cavernous
            -AVM
            -posterior fossa AVM w PICA aneurysm
            -Cavernoma1
            -Cavernoma2
            -Cavernoma3
            -Cavernoma4
            -cavernomas and DVA
            -cavernoma pontine w acute hemorrhage
               -Cavernous hemangioma of orbit
            -Right ICA stenosis with ischemic changes
            -MCA infarction
            -MCA infarction2
            -MCA infarction- dot sign
            -MCA infarction- dot sign
            -R M1 occlusion
            -Acute bilateral MCA infarcts
            -Hemorrhagic cerebellar infarction
            -PICA infarct R VA occlusion
            -Subacute infarct
            -Subacute hypoxic ischemic encephalopathy
            -Moya Moya Disease
            -Moya Moya Disease 2
            -Superior sagittal sinus thrombosis
            -Superior sagittal sinus thrombosis2
            -Dural sinus thrombosis with hemorrhagic venous infarcts
            -Dural Sinus Thrombosis
            -Dural Sinus Thrombosis 2
            -Straight sinus thrombosis
            -DVA with CVA
            -Capillary telangiectasia with DVA
            -Laminar necrosis
            -Anoxic brain injury
            -Anoxic brain injury2
            -CADASIL 1
            -CADASIL 2
            -Thoracic outlet syndrome
               -Vein of galen malformation
               -Jugular Diverticulum
            -Hypertensive encephalopathy
            -PRES
            -PRES 2
            -Fibromuscular dysplasia
            -ACA vasculitis
            -severe atherosclerotic disease with multifocal stenosis
            -Spinal DAVF
            -Nonaneurysmal Subarachnoid Hemorrhage

   -Inflammatory/Demyelinating/Infectious
           -herpes encephalitis
           -atypical herpes encephalitis
           -abscess
           -abscess2
           -abscess3
           -abscess4
           -abscess5
           -ventriculitis
           -ventriculitis2
           -thalamic abscess and ventriculitis
           -multiple abscesses and ventriculitis
           -temporal lobe abscess due to mastoiditis
           -suppurative adenitis
           -septic emboli
           -toxoplasmosis
           -toxoplasmosis2
           -meningitis with mastoiditis
           -Idiopathic Hypertrophic Pachymeningitis
           -laryngopyocele
           -mucormycosis
           -periapical cyst
           -Cholesterol Cyst
           -orbital pseudotumor
           -orbital pseudotumor2
           -orbital pseudotumor3
           -sarcoid1
           -sarcoid2
           -sarcoid3
           -sarcoid4
           -sarcoid5
           -sarcoid6
           -sarcoid7
           -sarcoid orbit
           -Wegener's granulomatosis dural
           -Reidel's thyroiditis
           -Ramsay Hunt Syndrome
           -Acute Disseminated Encephalomyelitis (ADEM)
           -CIDP
           -AIDP
             -cryptococcal meningitis
             -bacterial meningitis
             -meningoencephalitis
             -Subdural Empyemas
             -Listeria Meningitis with Vasculitis
             -malignant (necrotizing) otitis externa
             -frontal sinus mucocele
             -antrochoanal polyp
             -invasive fungal sinusitis
             -Chronic maxillary sinusitis, odontogenic origin
             -odontogenic abscess
              -dentigerous cyst w oral antral fistula
              -dentigerous cyst w oral antral fistula 2
             -Lyme Disease
              -progressive multifocal leukoencephalopathy
              -progressive multifocal leukoencephalopathy 2
              -progressive multifocal leukoencephalopathy 3
              -optic neuritis due to MS
              -active MS +DWI no enhancement
              -Multiple Sclerosis, spinal cord with active lesion
              -Susac Syndrome
              -tumefactive demyelination
              -tumefactive demyelination 2
              -neuromyelitis optica
           -lupus cerebritis
              -cysticercosis
              -racemose cysticercosis
              -cysticercosis3
              -acute parotitis
              -acute parotitis 2
              -vertebral osteomyelitis
              -discitis osteomyelitis epidural phlegmon
              -cervical discitis/osteomyelitis
              -septic facet disease
              -thoracic epidural abscess
              -epidural abscess 2
              -blastomycosis spondylitis
              -osteomyelitis, temporal bone
              -Central Skull Base Osteomyelitis
              -sphenoid sinus mucocele
              -TB adenitis
              -Histoplasmosis Supraclavicular
              -cryptococcal meningitis
           -cryptococcosis

    -Neoplastic
            -intraaxial
                -hemangioblastoma
                -hemangioblastoma2
                -hemangioblastoma IV recurrence
                -hemangioblastoma vHL
                -lymphoma1
                -lymphoma2
                -lymphoma3
                -lymphoma4
                -lymphoma5
                -lymphoma6
                -lymphoma6 intraventricular
                -Metastatic Choriocarcinoma
                -subependymoma
                -GBM
                -GBM corpus callosum
                -GBM w subependymal
                -GBM intraventricular recurrence
                -GBM spine w CSF dissemination
                -recurrent GBM w uncal herniation
                -recurrent GBM, corpus callosum
                -GBM left frontal
                -glioma/gliomatosis cerebri
                -multifocal GBM
                -GBM recurrence, dissemination
                -GBM recurrence, with dural sinus thrombosis
                -oligodendroglioma
                -pontine glioma
                -Gliosarcoma
                -central neurocytoma
                -central neurocytoma2
                -choroid plexus papilloma
                -Astrocytoma
                -pilocytic astrocytoma
                -pilocytic astrocytoma2
                -pilocytic astrocytoma suprasellar
                -grade 2 astrocytoma
                -anaplastic astrocytoma
                -anaplastic astrocytoma2
                -grade 3 astrocytoma
                -grade 3 astrocytoma 2
                -medulla astrocytoma
                -anaplastic oligodendroglioma
                -spinal cord astrocytoma
                -spinal cord astrocytoma pilocytic
                -PNET
                -trilateral retinoblastoma
                -Lhermitte Duclos
                -ganglioglioma
                -DNET
                -DNET2
                -DNET3 cerebellum
                -DNET4
                -tectal glioma
                -hamartoma of tuber cinereum
                -diffuse metastases, occult on noncon CT
                -metastatic choriocarcinoma
                -metastatic small cell lung
                -Metastatic Melanoma
                -metastatic melanoma w IVH
                -metastatic melanoma 3
                -intramedullary metastasis, lung
                -metastatic disease
                -metastatic disease 2
                -metastatic goblet cell
                -germinoma
                -germinoma2

            -extraaxial
                -dermoid1
                -dermoid2
                -chordoma1
                -chordoma2
                -chordoma3
                -squamous cell carcinoma, clivus
                -ependymoma
                -pineocytoma
                -epidermoid1
                -epidermoid2
                -epidermoid3
                -epidermoid4
                -epidermoid recurrent
                -carotid body tumor
                -glomus tympanicum
                -facial schwannoma
                -Meningioma 1
                -Meningioma 2
                -Meningioma 3
                -malignant grade 3 meningioma
                -Hemangiopericytoma
                -Meningioma, Olfactory groove and Planum
                -lipoblastic meningioma
                -intraventricular meningioma
                -V2 schwannoma
                -5th nerve schwannoma
                -IAC schwannoma
                -C3 foraminal/extraforaminal schwannoma
                -spinal hemangiopericytoma
                -ewing sarcoma
          -sellar/suprasellar
                -craniopharyngioma1
                -craniopharyngioma2
                -craniopharyngioma3
                -craniopharyngioma4
                -pituitary adenoma 1
                -pituitary adenoma 2
                -Minor salivary gland pleomorphic adenoma
            -other neoplasms
                -amelanotic melanoma
                -extraocular orbital melanoma
                -ocular melanoma
                -orbital lymphoma
                -orbital lymphoma2
                -orbital metastases, breast cancer
                -orbital hemangiopericytoma
                -chondrosarcoma
                -chondrosarcoma larynx2
                -chondrosarcoma 3
                   -rhabdomyosarcoma
                   -glomus jugulare
                -cholesteatoma
                -cholesteatoma2
                -inverting papilloma
                -spindle cell sarcoma
                -osteosarcoma, mandible
                -ameloblastoma
                -ameloblastoma2
                -tongue cancer with mets
                -tonsil cancer
                -T4 subglottic SCCA
                -T4 laryngeal SCCA
                -maxillary squamous cell carcinoma
                -adenoid cystic carcinoma
                -esthesioneuroblastoma
                -Choroid Plexus Carcinoma
                -perineural tumor spread
                -perineural tumor spread 2
                -lung cancer, vocal cord paralysis
                -nodal mets, follicular thyroid cancer
                -Warthin's tumor
                -Warthin's tumor2
                -Mucoepidermoid Carcinoma

                -lymphoma, submandibular gland
                -thyroid liposarcoma
                -thyroid lymphoma
                -verrucous carcinoma
                -spinal cord hemangioblastoma
                -pleomorphic adenoma2
                -pleomorphic adenoma

        -Congenital
            -lissencephaly
            -schizencephaly
            -schizencephaly3
            -open schizencephaly
            -closed lipped schizencephaly
            -hemimegalencephaly
            -Ruptured Dermoid
            -Suprasellar Dermoid
            -callosal agenesis
            -callosal agenesis, migrational anomaly, Dandy-Walker variant
            -band heterotopia
            -band heterotopia and AVM
            -Congenital Pedicle Duplication
            -Congenital Pedicle Absence
            -Congenital atlanto-occipital fusion with widened ADI
            -nodular heterotopia
            -nodular heterotopia2
            -persistent trigeminal artery1
            -persistent trigeminal artery2
            -aberrant internal carotid
            -persistent hypoglossal artery
            -aberrant RVA from arch
            -AICA from ICA
            -kissing carotids
            -internal carotid agenesis
            -ophthalmic origin from middle meningeal artery
            -jugular bulb dehiscence
            -3rd branchial cleft cyst
            -Thyroglossal Duct Cyst
            -2nd branchial cleft cyst
            -Mondini Malformation with Vestibular Aqueduct Syndrome
            -Vestibular Aqueduct Syndrome
            -Colloid cyst 1
            -Colloid cyst 2
            -Colloid cyst and meningioma
            -Colloid cyst and hippocampal infarcts
            -Hemorrhagic pineal cyst
            -Rathke's Cleft cyst
             -Chiari I malformation
            -Chiari II malformation
            -Chiari II malformation2
            -callosal agenesis with lipoma
            -Corpus Callosum Hypoplasia and lipoma
            -lipoma
            -intramedullary lipoma
            -Cistern Lipoma

            -lipomyelocele
            -complex spinal fusion anomalies
            -butterfly vertebra, aortic dissection
            -plexiform neurofibroma (NF1)
            -optic glioma (NF1)
            -bilateral acoustic neuromas- (NF2)
            -Neurofibromatosis type 2
            -Neurofibromatosis type 2(2)
            -Tuberous Sclerosis
            -Tuberous Sclerosis 2
            -hamartoma amygdala
            -Sturge Weber Syndrome
            -Sturge Weber Syndrome2
            -Hereditary Hemorrhagic Telangiectasia
            -Fahr's Disease
            -rhombencephalosynapsis
            -fibrous dysplasia1
            -fibrous dysplasia2
            -platybasia and basilar invagination
            -occult occipital encephalocele
            -venolymphatic malformation, orbit
            -ectopic neurohypophysis
            -
Progressive Multifocal Leukoencephalopathy

       -Trauma
            -skull fxs
            -dissection1
            -dissection2
            -B vertebral dissection
            -dissection with acute stroke
            -CTA brain dead
            -long t bone fx with IM dislocation
            -long t bone fx with IM dislocation 2
            -shear
            -multiple injuries
            -isodense SDH
            -acute on chronic SDH
            -acute SDH w edema
            -mult shears
            -DAI
            -subacute hemorrhagic contusions
            -Posttraumatic Subarachnoid Hemorrhage
            -fornix shear
            -EDH
            -EDH with active extrav
            -nonreducible TMJ disc dislocation
            -foraminal soft disc extrusion
            -cervical intradural disc extrusion
            -lumbar sequestered disc extrusion
            -Hirayama's Disease
            -lumbar SDH
            -occipital condyle fracture with widened AO joint
            -spinal cord transection
            -C5 flexion teardrop fracture
            -C5 burst fracture w VA dissection
            -tooth 8 fracture
            -burn injuries
            -distraction injuries C1-2 and C6-7
            -distraction injuries thoracic
            -perched facets
            -C6-7 with facet perch/lock
            -C2 fracture with rotatory subluxation, RVA occlusion
            -C2 Hangman's fx
            -complex tsp fx/disloc
            -C7 fx w cord contusion and hemorrhage
            -cystic myelomalacia
            -cystic myelomalacia 2
            -Traumatic ACA Pseudoaneurysm

       -Degenerative/Metabolic/Other
            -CO poisoning
            -chronic hypoxic ischemic encephalopathy
            -anoxic injury-electrocution
            -cerebral edema
            -mitochondrial disorder
            -amyloid2
            -CNS Amyloidoma
            -extensive prominent PVS w gliosis
            -superficial siderosis1
            -superficial siderosis2
            -cerebral edema
            -liver disease
            -CAPNON
            -laryngocele
            -dural fibrosis after shunt placement
            -otosclerosis w stapes prosthesis
            -otosclerosis w obliterative disease
            -otosclerosis
            -otosclerosis2
            -Osteoid Osteoma
            -semicircular canal dehiscence
            -semicircular canal dehiscence 2
            -CWD with stapes prosthesis extrusion
            -Wernicke's syndrome
             -Adrenoleukodystrophy
            -Leigh Disease
            -Huntington's Disease
            -extrapontine myelinolysis
            -central pontine myelinolysis
            -langerhans cell histiocytosis (EG) of orbit
            -intracranial hypotension
            -spontaneous intracranial hypotension
            -intracranial hypotension
            -SIH w cortical venous thrombosis
            -idiopathic intracranial hypertension
            -Wallerian degeneration
            -Multisystem Atrophy
            -Olivopontocerebellar Degeneration
            -Porencephalic cyst
            -ventral cord herniation
            -synovial cyst
            -bilateral mesial temporal sclerosis
            -mesial temporal sclerosis





Images contributed by current and former staff of the University of Cincinnati Neuroradiology department. Issues with images and links should be forwarded to udstueg@ucmail.uc.edu.

Disclaimer: The viewer is solely responsible for verification of the information presented. Diagnosis given is considered to be the most likely but not the only consideration for each case, and no claims are made of the validity of an individual diagnosis or of the information presented. In general, references are not listed since the concepts are those found in standard reference texts and the reader is encouraged to compare this information with his/her own knowledge resources. The information provided is not intended for use in diagnosis or treatment of any disease.