Ch. 11 - Developmental Abnormalities Flashcards Preview

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Flashcards in Ch. 11 - Developmental Abnormalities Deck (49)
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1

Arachnonid Cyst Definition

benign developmental cysts along craniospinal axis.

2

most common location of arachnoid cyst.

Sylvian fissure (50%) > cerebellopontine angle = quadrigeminal= supra sellar (10%) > other

location determines sx

3

sylvian fissure arachnoid cyst presentation

male > female. can be asymptomatic
classic: raised ICP and seizures
rare: rupture = focal neuro deficits

4

cerebellopontine angle arachnoid cyst presentation

sensorineural hearing loss, impairment of CNV, ataxia

5

suprasellar arachnoid cyst presentation

hydrocephalus, visual impairment, endocrine dysfxn

6

cerebral convexity arachnoid cyst presentation

seizures, HA, progressive hemiparesis
kids: asymmetrical enlargement of head

7

quadreminal arachnoid cyst presentation

mimic pineal masses. obstructive hydrocephalus and increased ICP

8

dx arachnoid cysts

CT/MRI, usually incidentalomas

9

tx arachnoid cyst

1. nothing if asymptomatic/no obstruction, regular follow up
2. craniotomy and drainage vs shunting

10

chiari malformation types

type 1: caudal displacement of cerebellar tonsils below foramen magnum
type 2: caudal displacement of cerebellar vermis, 4th vent, and medulla
type 3: caudal displacement of cerebellum and brainstem

11

syringomyelia

cavitation w/i spinal cord but outside central canal

12

hydromyelia

dilation of central canal 2/2 CSF cannot exit @ foramen of lushka/magendie and are transmitted down central canal

13

chiari malformation common association

syringomyelia, hydrocephalus
uncommon: CV anomolies, imperforate anus

14

causes of hydrocephalus in chiari

aqueduct stenosis/atresia/forking, fusion of superior/inferior colliculi, compression in posterior fossa

15

theories behind chiari malformation

1. tethered cord
2. differential pressure in intracranial/intraspinal fluid

16

Chiari I presentation

adolescent/adult-onset HA cape-like loss of pain/temp, long track signs (LE spasticity, UE paralysis), bulbar features 2/2 syrinx formation

17

Chiari II presentation

infant-onset. assoc. w/ myelomeningocele, progressive hydrocephalus, brainstem dysfxn (apnea, decreased gag, nystagmus, spastic paresis), adolescent/adult onset similar to chiari 1

18

How to dx chiari malformation

MRI - displacement of cerebellum into upper cervical canal

19

cause of hydromyelia

chiari malformations

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tx chiari malformation

1. posterior fossa and upper cervical decompression
2. shunt syrinx

21

craniovertebral jxn abnormalities

jxn of foramen magnum, occipital bone and atlas (C1)/axis (C2) resulting in underlying neurologic compression

22

basilar invagination

upward invagination of base of skull near foramen magnum into posterior fossa, shortening of clivus, odontoid protrusion

23

causes of basilar invagination

Paget's disease, osteomalacia, hyperPTH, Osteogenesis imperfecta

24

presentation basilar invagination

quadriparesis, dysphagia, respiratory difficulty, nystagmus, occipital HA

25

platybasia

obtuse basal angle joining the plain of the clivus with the plane of the anterior fossa

26

atlantoaxial dislocation associated with...

fusion of occiput to atlas and fusion of C2-C3 causes adjacent joint dz and instability, rheumatoid arthritis, trauma

27

Dandy Walker cyst

cystic enlargement of 4th vent, hypoplasia of cerebellum, hydrocephalus of 3rd and lateral ventricles

28

dandy walker cyst presentation

infantile: hydrocephalus
childhood: ataxia, delayed motor development

29

dandy walker cyst diagnosed via

CT/MRI

30

Dandy walker cyst tx

shunting of cyst