TENTIR RADIOLOGI KEPALA & SISTEM SARAF

Tampak Frontal

SINAR X

Tampak Lateral

ethmoid sinuses (E), frontal sinus (F), orbital roof (O), superior surface of the petrous portion of the temporal bone (P), sphenoid ridge (S), coronal suture (C), dens (D), anterior clinoid process (AC), dorsum sella (DS), sella turcica (ST), lambdoid suture (L), inner table of calvarium (IT), outer table of calvarium (OT), and sphenoid sinus (SS).

CT SCAN

CT-Scan Normal intracranial

Ganglia Basal white matter (left internal capsule) cerebrospinal fluid (CSF; frontal horn of the left lateral ventricle bone (skull)

MRI

Normal
Sagittal T1-weighted

axial T1-weighted

axial T2-weighted

Keterangan
gray matter (large arrows) white matter (curved arrows) CSF (small arrowheads) fat (small arrows) cortical bone (large arrowheads) genu (g) and splenium (s) of the corpus callosum (cc), fornix (f), optic chiasm (oc), pituitary gland (pit), midbrain (mb), pons (p), medulla (m), cerebellar vermis (Cb), straight sinus (SS), caudate head (c) putamen (pt) thalamus (T)

Kasus 1

A 47-year-old female presents with diabetes mellitus and recent development of left-sided hemiplegia. Axial images from an uninfused head CT examination

Area hipodens di sebelah kanan MCA (Middle Cerebral Artery) Parenkim terdesak ke kiri

Trombus Akut pd pembuluh darah (main trunk of MCA)

In case 1, what is the most likely diagnosis? a. Intracranial abscess b. Arachnoid cyst c. Metastatic brain tumor d. Primary brain tumor e. Cerebral infarction

Kasus 2

A 66-year-old woman presents with gradual onset of nausea, dizziness, and ataxia. The patient became comatose 24 hours after the onset of symptoms. Axial T2-weighted and sagittal T1-weighted images

Edema pd Serebelum

Ventrikel 4 terdesak Batang otak terdesak Herniasi tonsilar

In Case 2, what is the likely cause of the patient's problem? a. Brain stem infarction b. Brain stem compression from cerebellar infarction c. Brain stem tumor d. Cerebellar astrocytoma e. Posterior fossa hemorrhage

Kasus 3

A 42-year-old female hypertensive renal transplant patient presents with acute mental status changes and left hemiparesis. A single axial image from a noncontrast head CT scan

In case 1, what is the most likely diagnosis?

a. Thalamic glioma b. Subarachnoid hemorrhage c. Metastatic disease d. Hypertensive hemorrhage in the basal ganglia e. Cerebral contusion
Ganglia Basal Hematoma Ekstensi intraventrikular Bergesernya struktur tengah

KASUS 4

A 33-year-old Hispanic man presents with a syncopal episode and involuntary tremors. Noncontrast sagittal T1-weighted and axial T2-weighted images, as well as postcontrast axial T1-weighted images
Masa terlihat Heterogen Terdapat pseudocapsul

Masa terlihat Homogen dg parenkim otak

Setelah diberi kontras terlihat lapisan meningen (dura) Meningioma

 In Case 4, what is the most likely diagnosis?

a. b. c. d. e. Extra-axial brain tumor Intra-axial brain tumor Frontal contusion Subdural hematoma Encephalocele

Kasus 5

A 48-year-old woman presents with a history of headaches and seizures. Initial coronal T2-weighted FLAIR and axial contrastenhanced T1-weighted images

Hiperintens di inferior frontal regions & right temporal lobe dan perluasan ke corpus calosum Enhancement sudah mencapai hemisper kanan dan sebagian badan corpus calosum. Pada kasus ini terlihat seperti tumor ganas (anaplastic oligodendroglioma)

 In case 5, what is the most likely cause of the patient's symptoms?

a. b. c. d. e. Multiple sclerosis Inner ear abnormality Intraventricular meningioma Hematoma Malignant brain tumor

Kasus 6

A 43-year-old man (With HIV) presents with headache and weakness. An axial contrast-enhanced T1-weighted MR image
Lesi (enhancement) yg multiple, termasuk di daerah ganglia basal Lesi seperti ini biasanya terdapat pd orang dg HIV yg terinfeksi toksoplasma / terbentuknya limfoma intrakranial.

In Case 6, the major differential diagnosis for this lesion is toxoplasmosis versus??
a. b. c. d. e. cryptococcus. intracranial lymphoma. sarcoidosis. metastatic disease. cytomegalovirus (CMV).

Kasus 7

A young man who has been in a motor vehicle accident presents with a head injury. Soft-tissue window from an axial non-contrast head CT scan

What is the diagnosis?

a. b. c. d. e. Subdural hematoma Cerebral contusion Epidural hematoma Meningioma Subdural hygroma

The biconvex (cembung) appearance of this lesion is typical of an epidural hematoma