MRI Brain

MRI

Normal findings

  • Symmetric, no restricted diffusion
  • Normal flow voids in major vessels

Common abnormal findings

Acute infarct

  • Restricted diffusion on DWI
  • Low ADC
  • FLAIR positive after 6h

MS plaques

  • Ovoid periventricular FLAIR lesions
  • Perpendicular to ventricles (Dawson's fingers)
  • Enhancement = active

Tumour

  • T1 hypo/T2 hyper
  • Enhancement pattern
  • Surrounding oedema

Interpretation tips

  • DWI = most sensitive for acute infarct
  • Use SWI/GRE for blood products

Clinical correlation

  • Match imaging to clinical syndrome (NIHSS, time of onset)
  • Enhancement pattern guides DDx (ring = abscess/met/GBM)

Common mistakes

  • Calling old infarct as new without DWI/ADC
  • Missing leptomeningeal enhancement (meningitis/met)

Educational support only — not a substitute for clinical judgment.

WardRound

WardRound

Clinical Decisions in Seconds