Acute vs chronic symptomatolgy:
Acute ddx:
- hypoxic-ischaemic encephalopathy (cardiac or respiratory arrest)
- vascular insults
- toxin/drug
- hypoglycemia (high T2/FLAIR) / hypeglycemia (high T1)
Site:
- basal ganglia and cortes > hypoxic or CJD
- thalamus: hockey stick sign > variant CJD
- caudate atrophy > huntington
- globus pallidus - eye of the tiger: T2 hyperintense centre surrounded by T2 hypointense rim from iron accumulation > NBIA Neurodegeneration with Brain Iron Accumulation / paediatric patients
- globus pallidus > CO poisoning.
- putamen > cyanide and methanol. may result in haemorrhagic necrosis of putamen. methanol may present with optic neuritis
- medial thalami infarcts: artery of Percheron or internal cerebral vein thrombosis
Signal characteristics:
high T1 > hepatic encephalopathy, parenteral nutrition, hypermagnesemia, non-ketotic hyperglycemic state, Wilson's
also high T1 in internal cerebral vein or straight sinus > thrombosis
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