Neuro Flashcards by AS Mendoza

Q

Most sensitive standard sequence for detecting subacute subdural hematoma

A

FLAIR

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Q

Rare case of chronic subdural hematoma densely calcifiying or even ossifying

A

armored brain

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Q

CT appearance of brain with severe cerebral edema - hypodense brain makes circulating blood in arteries and veins look relatively hyperdense

A

pseudosubarachnoid hemorrhage

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Q

Most severe manifestation of frank brain laceration

A

burst lobe

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Q

Cutoff of abnormal tonsils below the foramen magnum especially if they are peg-like or pointed (rather than rounded)

A

> 5 mm

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Q

Earliest sign of posttraumatic brain swelling

A

subfalcine herniation > or = 3 mm than width of epidural or subdural hematoma

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Q

What conditions do typically cause hemorrhages at gray-white matter interface?

A

mets, septic emboli, and fungal

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Q

What intracranial hemorrhage is a common association with intracranial hypotension?

A

subdural hematoma

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Q

Posterior fossa neoplasms that frequently hemorrhage

A

ependymoma and rosette-forming glioneural tumor

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Q

Supratentorial tumors with a propensity to bleed

A

ependymoma and the spectrum of PNETs (malignant astrocytomas with hemorrhage are rare)

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Q

Convexal SAH in > or = 60 yo

A

think cerebral amyloid angiopathy (CAA)

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Q

Convexal SAH in < or = 60 yo

A

think reversible cerebral vasoconstriction syndrome (RCVS)

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Q

What artifact is the major imaging mimic of classic superficial siderosis?

A

bounce point artifact

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Q

Giant saccular aneurysm size

A

2.5 cm or > (sa table 2 cm)

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Q

Aneurysm size associated with a significantly increased risk of rupture compared with 2-4-mm aneurysms

A

> or = 5 mm

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Q

Other risks for aneurysmal rupture:

A

growth on surveillance imaging

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Q

Other risks for aneurysmal rupture:

A

nonsaccular (nonspherical) shape

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Q

Other risks for aneurysmal rupture:

A

daughter sac (irregular wall protrusion) and increased aspect ratio (length compared to width) - independent predictors

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Q

Other risks for aneurysmal rupture:

A

vertebrobasilar and ICA-PCoA - highest risk

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Q

Other risks for aneurysmal rupture:

A

MCA and ACA - modest risk

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Q

Other risks for aneurysmal rupture:

A

prior history of SAH - independent risk factor

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Q

Size of giant cerebral cavernous malformation (CCM)?

A

> 6 cm

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Q

What Zabramski type is the classic CCM appearing as a popcorn ball?

A

Zabramski type II (pag multiple microhemorrhages iyong appearance, type IV)

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Q

7 ICA segments:

A

C1 - cervical

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8 ICA segments:

C2 - petrous

9 ICA segments:

C3 - lacerum

10 ICA segments:

C4 - cavernous

11 ICA segments:

C5 - clinoid

12 ICA segments:

C6 - ophthalmic

13 ICA segments:

C7 - communicating

Only CN that lies inside the cavernous sinus itself?

abducens (CN VI)

How many components do the the circle of Willis have?

10

In MS lesions especially large tumefactive lesions, where does the "open" nonenhancing segment of the horseshoe enhancement face?

cortex

2010 McDonald criteria for MS:

Dissemination in space - ≥1 T2 hyperintense lesion(s) in at least 2 of these 4 areas (periventricular, juxtacortical, infratentorial, spinal cord)

2016 MAGNIMS recommended modification:

Dissemination in space - ≥3 periventricular lesions, add optic nerve as additional location, make juxtacortical to cortical/juxtacortical

SEGA virtually always occurs in the setting of?

tuberous sclerosis

3 inherited cancer syndromes that demonstrate an enhanced propensity to develop IDH-wild-type GBMs?

NF1, Li-Fraumeni, and Turcot syndrome

Choroid plexus papillomas occur with?

Aicardi, Li-Fraumeni, rhabdoid predisposition syndromes

aka hypophysis cerebri?

pineal gland

What is the rarest, most malignant of all intracranial GCTs?

primary intracranial choriocarcinoma

*What brain tumor commonly presents with foraminal / lateral extension into the CPA?

ependymoma

Most important site for CSF turnover

dura mater aka pachymeninx

Only established environemental risk factor for meningioma

radiation

Imaging triad that is present in most anaplastic meningiomas

extracranial mass, osteolysis, mushrooming intracranial tumor

Where do chondrosarcomas classically arise from?

petrooccipital fissure

What pathology causes a pupil-involving third nerve palsy?

PCoA aneurysm - located in close proximity to the cisternal segment of the nerve (pupilloconstrictor fibers of the nerve are located in the periphery of the nerve along its superolateral aspect)

What pathology causes a pupil-sparing third nerve palsy?

microvascular infarction of the core of the nerve

Which CN is especially vulnerable to injury during closed head trauma because of the long course of its cisternal segment and its proximity to the tentorium?

CN IV (symptom: torticollis/wry neck/head tilt)

Which CN is vulnerable to apical petrocitis as well as increased ICP?

CN VI

CN VII exits through what foramen?

stylomastoid foramen

Which of the four nerves within the IAC is the most anterosuperior?

CN VII ("7 up, coke down" tapos sa likod iyong superior and inferior vestibular nerves)

Which is the only CN with segments that may exhibit some enhancement?

CN VII

Which of the segments of the INFRATEMPORAL facial nerve is not surrounded by a robust vascular plexus?

labyrinthine segment (therefore, kung nag-enhance baka always abnormal?)

Which of the infratemporal facial nerve branches is affected first in the invasion of malignant parotid tumors through the stylomastoid foramen?

chorda tympani (kasi most distal; taste anterior 2/3) -> stapedius nerve (hyperacusis) -> greater superficial petrosal nerve (parasympathetic lacrimal gland)

What bony bar separates the superior and inferior vestibular nerves?

falciform (transverse) crest

In the coronal plane of the jugular tubercle and basiocciput, what structure represents the "eagle's head"?

jugular tubercle

In the coronal plane of the jugular tubercle and basiocciput, what foramen/canal lies superolateral to the "eagle's head and beak"?

jugular foramen

In the coronal plane of the jugular tubercle and basiocciput, what foramen/canal lies under the "eagle's head and beak" / at the "neck" between the "beak" above and "body" below?

hypoglossal canal

Which of the 3 CNs that exit through the jugular foramen lies in the pars nervosa (anterior part)?

CN IX (CN X and XI lies in the pars vascularis/posterior part)

What are the 3 compartments involved in a 3-component trigeminal schwannoma?

Meckel cave, posterior fossa through the porus trigeminus, and masticator space through the foramen ovale

Osseous mets are relatively rare in children except in what malignancy?

Neuroblastoma

Upper normal limit of pituitary height (coronal T1)

6 mm - prepubescent children

Upper normal limit of pituitary height (coronal T1)

8 mm - men and postmenopausal women

Upper normal limit of pituitary height (coronal T1)

10 mm - puberty and young menstruating

Upper normal limit of pituitary height (coronal T1)

12-14 - pregnant and postpartum lactating

What is the rule of ninety in adamantinomatous craniopharyngiomas?

90% mixed cystic/solid, 90% calcified, and 90% enhance

The only one of the nonadenomatous tumors that can present as a purely intrasellar mass

pituicytoma

Single most impt risk factor for developing new primary CNS neoplasms

radiation therapy

What is the typical topographical pattern or progression of normal myelination?

inferior to superior, central to peripheral, posterior to anterior (Is CP pa?)

Obligatory hallmark of Joubert syndrome and JS-related disorders

molar tooth sign

Virtually pathognomonic of NF1

plexiform neurofibromas

Earliest manifestation of NF1

cafe-au-lait spots/macules

Major feature of NF2

schwannomas

Differentiate NF1 and NF2 in terms of their associated neoplasms

NF1=astrocytomas, NF2=ependymomas and meningiomas

Second pathologic hallmark of NF2

multiple meningiomas

Classic clinical triad of tuberous sclerosis complex

facial lesions (adenomata sebaceum), seizures, mental retardation

Hallmark of type 2 VHL

adrenal pheochromocytoma

Meaning of PHACE syndrome

Posterior fossa malformations, Hemangioma, Arterial cerebrovascular anomalies, Coarctation of aorta and cardiac defects, and Eye abnormalities (PHACES - Sternal clifting or supraumbilical raphe)

Normal order of suture closure

metopic > coronal > lambdoid > sagittal

Classification of craniosynostosis by head shape:

1. scaphocephaly / dolicocephaly

Classification of craniosynostosis by head shape:

2. brachycephaly

Classification of craniosynostosis by head shape:

3. trigonocephaly

Classification of craniosynostosis by head shape:

4. plagiocephaly

Other skull deformities:

turricephaly

Other skull deformities:

oxycephaly

Other skull deformities:

Kleeblattschadel