Leptomeningeal FLAIR Hyperintensity Differential Diagnosis

Hyper intensity in the subarachnoid space can have a wide range of causes. The finding may be subtle to detect at times. However, identifying it can be crucial in altering a patient's management. The mnemonic FLAIR can be used to recall the common causes of this finding:

DiseaseNotes
FFiO2 highNo contrast enhancement
LLeptomeningeal spread of tumorGEMCLOG: glioblastoma, ependymoma, medulloblastoma, choroid plexus tumor, lymphoma, oligodendroglioma, germinoma
AAneurysmal bleedNo contrast enhancement
IInfection (meningitis)
RpRopofolNo contrast enhancement, may also be due to increased oxygen



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