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Radiology
White Matter and Neurodegenerative Diseases
Built from Fundamentals of Diagnostic Radiology
What’s inside
9 sections · 95 slides
White Matter Foundations
What white matter is, how MRI shows its diseases, and how they are classified
- What white matter is
- How MRI detects white matter disease
- Two broad classes of white matter disease
- Four categories of demyelinating disease
- White matter disease classification
Primary Demyelination
Multiple sclerosis and its imaging mimics
- Multiple sclerosis at a glance
- How multiple sclerosis is diagnosed
- What MS lesions look like
- Multiple sclerosis plaques
- FLAIR and where MS likes to sit
- Locations that raise MS suspicion
- Incidental white matter spots
- Incidental punctate white matter foci
- Tumefactive MS (TDL)
- Tumefactive demyelinating lesion
- MS in the spinal cord
Ischemic Demyelination
Small-vessel disease, vasculitis, and their mimics
- Age-related small-vessel disease
- Naming and meaning of white matter changes
- Ischemic demyelination
- Ischemia versus MS in the older patient
- Causes of punctate white matter lesions
- Antiphospholipid antibody syndrome
- Antiphospholipid antibody syndrome
- CNS vasculitis and lupus
- Lupus cerebritis
- Moyamoya disease
- Moyamoya disease
- Drug-induced vasculopathy
- Drug-induced vasculopathy
- Ependymitis granularis
- Ependymitis granularis (normal finding)
- Virchow–Robin (perivascular) spaces
- Virchow–Robin (perivascular) spaces
- CADASIL disease
- CADASIL disease
Infection-Related Demyelination
Viral white matter disease
- Herpes encephalitis
- Where herpes attacks
- Herpes encephalitis
- ADEM
- ADEM imaging and outcome
- Acute disseminated encephalomyelitis
- Progressive multifocal leukoencephalopathy
- Progressive multifocal leukoencephalopathy
- HIV encephalopathy
- Subacute sclerosing panencephalitis
Toxic and Metabolic Demyelination
Osmotic, radiation, and nutritional injury
- Central pontine myelinolysis (CPM)
- Why CPM happens
- Imaging CPM and extrapontine myelinolysis
- Osmotic demyelination (central and extrapontine)
- PRES
- PRES mechanism
- Causes of PRES
- PRES imaging notes
- Posterior reversible encephalopathy syndrome
- Marchiafava–Bignami and Wernicke–Korsakoff
- Wernicke imaging
- Radiation leukoencephalopathy
- Radiation leukoencephalopathy
- Radiation necrosis
- Separating necrosis from tumor
- Radiation necrosis
- Radiation plus methotrexate
Dysmyelinating Diseases
Inherited leukodystrophies
- What dysmyelination means
- Dysmyelinating disease classification
- Metachromatic leukodystrophy
- Adrenal leukodystrophy
- Adrenal leukodystrophy
- Leigh disease
- Leigh disease
- Alexander and Canavan diseases
- Canavan disease
Cerebrospinal Fluid Dynamics
Hydrocephalus and its mimics
- How CSF flows
- Hydrocephalus basics
- Two kinds of hydrocephalus
- Signs of hydrocephalus
- Obstructive hydrocephalus
- Ex vacuo ventriculomegaly versus hydrocephalus
- Causes of hydrocephalus
- Acute versus chronic hydrocephalus
- Normal pressure hydrocephalus (NPH)
Neurodegenerative Disorders
Dementia, movement disorders, and basal ganglia disease
- Alzheimer disease (AD)
- Alzheimer disease
- Imaging Alzheimer disease
- Parkinson disease
- Imaging Parkinson disease
- Huntington disease
- Huntington disease
- Wilson disease
- Other basal ganglia insults
- Carbon monoxide toxicity
Summary
Key points to take away
- Key takeaways — demyelination
- Key takeaways — hydrocephalus and neurodegeneration
- The radiologist's role
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology