How neuro and head and neck is examined
Phase 2 of the RANZCR clinical radiology training program is assessed with examinations that test image interpretation, pathology knowledge and clinical reasoning across body systems. Formats and weightings change, so check the current RANZCR examination information and Phase 2 learning outcomes.
High-yield topics
| Topic | Key imaging points |
|---|---|
| Stroke | Non-contrast CT, CTA, perfusion core and penumbra |
| Haemorrhage | Ageing of blood on MRI |
| Tumours | Enhancement and diffusion patterns |
| Demyelination | MS lesion locations |
| Head and neck | Nodal levels and cancer staging |
Worked questions
Worked question · MS
Which lesion location is typical of multiple sclerosis?
- A Periventricular, perpendicular
- B Basal ganglia only
- C Cortical and wedge-shaped
- D Central pons only, sparing the rest
- E Watershed zones
Show the reasoning
Answer A. MS plaques are classically periventricular, oriented perpendicular to the ventricles (Dawson fingers), plus juxtacortical, infratentorial and spinal cord lesions.
A search pattern for reporting
- Clinical question and timing (stroke onset)
- Haemorrhage: extra-axial and intra-axial
- Grey-white differentiation and early ischaemia
- Mass effect, midline shift, herniation
- Ventricles and CSF spaces
- Posterior fossa and skull base
- Bones, sinuses, orbits and soft tissues
Use the same order every time so that nothing is missed under exam conditions, then finish with a concise conclusion and recommendation.
Signs and differentials to know
| Imaging sign or finding | Think of |
|---|---|
| Ring-enhancing lesion | Metastasis, abscess, glioblastoma, demyelination, lymphoma |
| Restricted diffusion in a ring | Abscess |
| Hyperdense MCA sign | Acute MCA thrombus |
| Crescentic extra-axial collection crossing sutures | Subdural haematoma |
| Lentiform collection limited by sutures | Extradural haematoma |
| Cerebellopontine angle mass | Vestibular schwannoma, meningioma |
A 4-week revision block
| Week | Focus |
|---|---|
| 1 | Stroke and haemorrhage |
| 2 | Tumours and infection |
| 3 | Demyelination and spine |
| 4 | Head and neck and mixed |
Pair reading with daily timed questions and image review on teaching files, and log every missed structure or sign.
Common traps
- Mis-ageing haemorrhage.
- Missing early ischaemic signs.
- Unclear nodal levels.
Free sample neuro and head and neck questions
Questions from our Radiology Phase 2 bank. Choose your answer, then open the explanation.
Empty delta sign on contrast CT suggests:
- ANormal variant
- BSubdural empyema
- CArteriovenous malformation
- DMeningioma
- EVenous sinus thrombosis
Show answer and explanation
Answer E. Filling defect in the sinus with enhancing walls; venous infarcts are often haemorrhagic and non-arterial.
Learning point: Empty delta: sinus thrombosis.
What is the first-line imaging for suspected subarachnoid haemorrhage within 6 hours of headache onset?
- ASkull radiograph
- BCatheter angiogram first
- CNon-contrast CT brain
- DMRI with gadolinium
- ECarotid ultrasound
Show answer and explanation
Answer C. Non-contrast CT within 6 hours is highly sensitive for SAH. CTA identifies aneurysms.
Learning point: Suspected SAH: non-contrast CT first.
A lentiform hyperdense collection that does not cross sutures is:
- AIntraventricular haemorrhage
- BSubdural haematoma crossing sutures
- CExtradural haematoma
- DSubarachnoid haemorrhage
- EContusion
Show answer and explanation
Answer C. EDH is biconvex, limited by sutures, often from middle meningeal artery with fracture. SDH is crescentic and crosses sutures.
Learning point: EDH: lentiform, does not cross sutures.
Practise more neuro and head and neck questions free
Every neuro and head and neck subtopic in our bank
The bank holds 16 neuro and head and neck questions across 16 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Cerebral venous thrombosis1
- Cord compression1
- Diffuse axonal injury1
- Diffusion restriction1
- Extradural haematoma1
- Glioblastoma1
- Hydrocephalus1
- Meningioma1
- Multiple sclerosis1
- Posterior reversible encephalopathy1
- Ring-enhancing lesion1
- SAH1
- Spinal cord compression1
- Stroke CT1
- Subarachnoid haemorrhage1
- Temporal bone fracture1
Common questions
What does Phase 2 assess?
Image interpretation, pathology and clinical reasoning across body systems. Check RANZCR for current formats.
How should I practise?
Daily timed questions with image review, and structured reporting practice.
Is perfusion imaging tested?
Stroke imaging including CTA and perfusion is a core neuroradiology topic.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.