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ABPP > Cranium, ventricles, & meninges > Flashcards

Cranium, ventricles, & meninges Flashcards

1
Q

The blood-CSF barrier is formed by

A

Choroid epithelial cells

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2
Q

Usual cause of subdural hematoma

A

Rupture of bridging veins, which are particularly vulnerable to shear injury

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3
Q

The middle meningeal artery runs through the

A

Epidural space

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4
Q

The blood-brain barrier is made up of

A

Capillary endothelial cells

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4
Q

Consequences of early hydrocephalus on brain development

A

Stretch or destroy CC; affects WM tracts, esp. projection fibers near midline; disrupt myelination, resulting in decreased cortical mantel; decreased brain mass, thinning of posterior brain regions; multiple surgeries to correct shunt

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5
Q

Radiological appearance of epidural hematoma

A

Lens-shaped biconvex hematoma, usually does not spread past cranial sutures where dura is attached to the skull

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6
Q

Mild central herniation can lead to traction on which cranial nerve?

A

CN VI, producing lateral rectus palsy

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7
Q

Normal intracranial pressure

A
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8
Q

Meninges, from inside to outside

A

Pia, arachnoid, dura

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8
Q

Tentorium cerebelli

A

Tentlike sheet of dura that covers the upper surface of the cerebellum

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9
Q

Cisterns

A

Widening of subarachnoid space to form large CSF lesions

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9
Q

Symptoms of increased CSF

A

Headache worse lying down, altered mental status (irritability, depressed alertness & attention), nausea/vomitting, papilledema, visual loss, diplopia

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10
Q

CSF enters the subarachnoid space via

A

Lateral foramina of Luschka & midline foramen of Magendie

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11
Q

Subarachnoid space

A

CSF-filled space between the arachnoid & pia; major arteries of the brain travel through this space

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12
Q

Falx cerebri

A

Separates the 2 cerebral hemispheres

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14
Q

What is the normal adult volume of CSF?

A

150cc, 500cc produced per day

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16
Q

Choroid plexus

A

Epithelial tissue in ventricular system that secretes CSF; found in the lateral ventricles & the roof of the 3rd & 4th ventricles

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17
Q

The bridging veins run through the

A

Subdural space

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17
Q

What type of herniation can cause infarcts in the ACA territory?

A

Subfalcine herination

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17
Q

Xanthochromia

A

CSF discoloration due to presence of blood for 1+ day; associated with subarachnoid hemorrhage

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18
Q

Most common cause of epidural hematoma

A

Rupture of the middle meningeal artery due to fracture of the temporal bone by head trauma

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19
Q

Arachnoid layer

A

Adheres to inner surface of dura

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20
Q

The cervicomedullary junction occurs at the level of the

A

Foramen magnum

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21
Q

What type of herniation is associated with compression of the medulla

A

Tonsillar herniation Leads to respiratory arrest, BP instability, death

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22
Q

Radiological appearance of subarachnoid hemorrhage

A

Blood tracks down into sulci following contours of the pia

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22
Q

Pia mater

A

Adheres closely to the surface of the brain & surrounds the initial portion of each blood vessel as it penetrates the brain surface

23
Q

Hydrocephalus can result from

A

Increased production/decreased absorption of CSF Blockage of one of the normal outflow pathways of the ventricular system

24
Q

Kernohan’s phenomenon

A

As midbrain is pushed to side by uncus in uncal herniation, it is pushed away from the side of the mass. The side opposite the mass then becomes compressed against the tentorial notch, leading to ipsilateral hemiplegia.

25
Q

What is the most common cause of lobar hemorrhage?

A

Amyloid angiopathy

26
Q

Tentorium cerebelli

A

Covers the upper surface of the cerebellum

28
Q

Pseudotumor cerebri

A

Elevated ICP/edema without mass lesion

28
Q

Leptomeninges

A

Pia & arachnoid

29
Q

Neuropsych effects of hydrocephalus in children

A

PIQ< language problems with rapid retrieval of info, automaticity, language discourse, cocktail party speech Deficits in both verbal & visual memory, exec deficits

30
Q

Communicating hydrocephalus

A

Excess CSF due to either bad absorption or over production

30
Q

Colloid cyst

A

Benign neoplasm composed of epithelial cells surrounded by a capsule & filled with a gelatinous substance; commonly arise from the roof of the 3rd ventricle

31
Q

Ventriculostomy

A

Establishes free communication between the floor of the 3rd ventricle & the underlying interpeduncular cistern

32
Q

Hypertensive hemorrhages are most common in what areas of the brain?

A

BG, thalamus, cerebellum, pons

33
Q

Is vasospasm more common in traumatic or nontraumatic subarachnoid hemorrhage?

A

Nontraumatic

35
Q

Symptoms of chronic subdural hematoma

A

HA, cognitive impairment, unsteady gait

36
Q

Cerebral aqueduct/Aqueduct of Sylvius

A

Canal draining CSF from 3rd to the 4th ventricles through the midbrain; common site of obstruction causing childhood hydrocephalus

37
Q

What pattern of IQ performance is typically observed in children with early-onset hydrocephalus?

A

VIQ>PIQ

38
Q

Calvaria/calvarium

A

Upper dome-like portion of the skull

40
Q

Risk factors of pseudotumor cerebri

A

Female, adolescent, obesity, menstrual abnormalities

41
Q

Clinical triad of uncal herniation

A

Blown pupil (compression of CN III), HP (compression of cerebral peduncles), coma (distortion of midbrain RF)

42
Q

What is the most common cause of nontraumatic subarachnoid hemorrhage?

A

Rupture of arterial aneurysms (75-80%)

43
Q

The anterior, middle, & posterior fossa contain which brain structures?

A

Anterior - frontal lobe Middle - temporal lobe Posterior - cerebellum & brainstem

45
Q

Radiological appearance of subdural hematoma

A

Crescent-shaped

46
Q

Which brain region is most often affected by hydrocephalus?

A

Posterior regions

47
Q

Obstructive hydrocephalus

A

Obstruction of CSF drainage from the lateral & 3rd venricles; commonly seen with brainstem tumor or posterior fossa tumor; can result from congenital stenosis of aqueduct of Sylvius

48
Q

What 3 ways is hydrocephalus classified?

A

Complicated or noncomplicated Communicating or noncommunicating Congential or postnatal

50
Q

Cushing’s triad

A

HTN, bradycardia, irregular respiration

51
Q

Most common cause of perinatal & postnatal hydrocephalus (besides spina bifida)

A

Intraventricular hemorrhage

53
Q

Vasogenic vs cytotoxic edema

A

Vasogenic: excessive extracellular fluid Cytotoxic: excessive intracellular fluid within brain cells caused by cellular damage

54
Q

Cocktail party syndrome (CPS)

A

Communication style characterized by excessive verbiage that lacks clarity, organization, & relevance (often seen in childhood hydrocephalus)

55
Q

In what areas is the blood-brain barrier broken?

A

Pituitary gland (entry of chemicals that influence hormones), pineal gland (entry of chemicals that affect day-night cycles), area postrema (entry of toxic substances that induce vomiting

56
Q

Two layers of the dura

A

Periosteal & meningeal

57
Q

Children with prenatal obstructive hydrocephalus are more prone to exhibit difficulties with

A

Visuospatial & visuomotor abilities

58
Q

How is increased CSF/ICP treated?

A

Steroids, mannitol, hyperventilation (vasoconstriction), shunt, external ventricular drain

59
Q

Dura mater

A

Outermost meningeal layer

60
Q

Alterations in the amount of CSF may reflect

A

Nervous system impairment (bacterial meningitis, myelitis, MS, SAH) or germ cell proteins

61
Q

Symptoms of nontraumatic subarachnoid hemorrhage

A

Sudden catastrophic HA, meningeal irritation, CN & other focal deficits, impaired consciousness

62
Q

Symptoms of pseudotumor cerebri

A

Generalized, bilateral headache, bilateral VI palsy, visual deficits due to swelling of optic disk

63
Q

Falx cerebri

A

Suspended from roof of cranium, separates left & right hemispheres

ABPP (34 decks)

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