Flashcards in Ch. 11 - Developmental Abnormalities Deck (49)
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Arachnonid Cyst Definition
benign developmental cysts along craniospinal axis.
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most common location of arachnoid cyst.
Sylvian fissure (50%) > cerebellopontine angle = quadrigeminal= supra sellar (10%) > other
location determines sx
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sylvian fissure arachnoid cyst presentation
male > female. can be asymptomatic
classic: raised ICP and seizures
rare: rupture = focal neuro deficits
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cerebellopontine angle arachnoid cyst presentation
sensorineural hearing loss, impairment of CNV, ataxia
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suprasellar arachnoid cyst presentation
hydrocephalus, visual impairment, endocrine dysfxn
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cerebral convexity arachnoid cyst presentation
seizures, HA, progressive hemiparesis
kids: asymmetrical enlargement of head
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quadreminal arachnoid cyst presentation
mimic pineal masses. obstructive hydrocephalus and increased ICP
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dx arachnoid cysts
CT/MRI, usually incidentalomas
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tx arachnoid cyst
1. nothing if asymptomatic/no obstruction, regular follow up
2. craniotomy and drainage vs shunting
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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
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syringomyelia
cavitation w/i spinal cord but outside central canal
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hydromyelia
dilation of central canal 2/2 CSF cannot exit @ foramen of lushka/magendie and are transmitted down central canal
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chiari malformation common association
syringomyelia, hydrocephalus
uncommon: CV anomolies, imperforate anus
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causes of hydrocephalus in chiari
aqueduct stenosis/atresia/forking, fusion of superior/inferior colliculi, compression in posterior fossa
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theories behind chiari malformation
1. tethered cord
2. differential pressure in intracranial/intraspinal fluid
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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
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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
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How to dx chiari malformation
MRI - displacement of cerebellum into upper cervical canal
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cause of hydromyelia
chiari malformations
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tx chiari malformation
1. posterior fossa and upper cervical decompression
2. shunt syrinx
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craniovertebral jxn abnormalities
jxn of foramen magnum, occipital bone and atlas (C1)/axis (C2) resulting in underlying neurologic compression
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basilar invagination
upward invagination of base of skull near foramen magnum into posterior fossa, shortening of clivus, odontoid protrusion
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causes of basilar invagination
Paget's disease, osteomalacia, hyperPTH, Osteogenesis imperfecta
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presentation basilar invagination
quadriparesis, dysphagia, respiratory difficulty, nystagmus, occipital HA
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platybasia
obtuse basal angle joining the plain of the clivus with the plane of the anterior fossa
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atlantoaxial dislocation associated with...
fusion of occiput to atlas and fusion of C2-C3 causes adjacent joint dz and instability, rheumatoid arthritis, trauma
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Dandy Walker cyst
cystic enlargement of 4th vent, hypoplasia of cerebellum, hydrocephalus of 3rd and lateral ventricles
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dandy walker cyst presentation
infantile: hydrocephalus
childhood: ataxia, delayed motor development
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dandy walker cyst diagnosed via
CT/MRI
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