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Arab Board Radiology Final Written study materials
Arab Board Radiology Final Written study resources

Arab Board Radiology Final Written: Neuroradiology: Brain, Spine, Head and Neck

Arab Board Radiology Final Written · Work through your exam, one topic at a time.

All guide sections

Neuroradiology: Brain, Spine, Head and Neck

Core concepts

Master the stroke timeline and vascular territories: MCA/ACA/PCA supply, watershed zones, and the imaging evolution of infarction (loss of grey-white differentiation and insular ribbon sign on CT, restricted diffusion on DWI within minutes, pseudonormalisation at 1–2 weeks, encephalomalacia later). Know haemorrhage patterns: hypertensive basal ganglia/thalamic, lobar (amyloid, metastasis), subarachnoid (aneurysm, convexity from superficial siderosis). Understand intracranial mass approach: age, location, ring enhancement, perfusion and MR spectroscopy. For spine, know discitis-osteomyelitis (endplate destruction, fluid in disc on T2), epidural abscess, and cord compression red flags. Head and neck: nodal levels I–VI, the spaces (parapharyngeal, masticator, carotid, retropharyngeal) and their contents.

Traps

  • Hyperdense MCA sign is a sign of thrombus, not haemorrhage-do not confuse with SAH.
  • Diffusion restriction is not specific for infarct; abscess, cellular tumour and CJD also restrict.
  • Ring-enhancing lesions: a thin smooth ring suggests abscess; thick irregular ring suggests tumour or demyelination.
  • In spinal infection, sparing of the disc favours metastasis; involvement of the disc favours infection.
  • Posterior reversible encephalopathy syndrome (PRES) is typically parieto-occipital and often reversible-do not call it infarct.

Worked example / rule of thumb

A 60-year-old with sudden right hemiparesis: a non-contrast CT is normal at 90 minutes. A normal CT does not exclude stroke; proceed to CTA (large-vessel occlusion) and MRI DWI. Rule of thumb: CT excludes haemorrhage; MRI confirms infarction. For the spine, if there is cord signal change plus compression, the urgency is surgical, not merely antibiotic.

Key points

  • Know the vascular territories and the temporal evolution of infarct on CT/MRI.
  • Diffusion restriction has a differential; do not equate it with stroke alone.
  • Distinguish infection from tumour in the spine by disc involvement.
  • Learn the head and neck spaces and cervical nodal levels.
  • Recognise PRES, hypertensive haemorrhage, and SAH patterns.