Neurology lists Flashcards

Question

What area of the brain is seen in superior sagittal sinus thrombosis?

Answer 1

Parasagittal high convexity cortex

Answer 2

Infarction of bilateral thalami

Answer 3

Posterior temporal lobe infarct

Answer 4

* Hypertensive haemorrhage * Amyloid angiopathy * Aneurysmal haemorrhage * AVM * dAVF * Cavernous malformation * Venous thrombosis * Haemorrhagic neoplasm * Haemorrhagic infarct * CNS vasculitis * Moyamoya

Answer 5

* Mucopolysaccharidoses * Gelatinous pseudocysts in cryptococcal meningitis * atrophy

Answer 6

* Babies are born with the brainstem and posterior limb of the internal capsule myelinated * Order of myelination * inferior to superior * posterior to anterior * Central to peripheral * sensory before motor

Answer 7

1. Maxillary (5 months) 2. Ethmoid (1 year) 3. Sphenoid (6 years) 4. Frontal (4 years)

Answer 8

Chiari type II malformation: Chiari type II malformation presents with deformity of the brainstem and enlargement of the foramen magnum. It is associated with myelomeningocele. • Spinal hypotension syndrome: This is characterized by downward displacement of the cerebellar tonsils secondary to low pressure within the spinal canal. The brainstem and 3rd ventricle “sag” inferiorly, and the pituitary gland is upwardly convex. If contrast is administered, dural thickening and enhancement are demonstrated

Answer 9

Associated anomalies are shortening of the clivus, basilar invagination, C1 assimilation, and fused cervical vertebrae (Klipper-Feil syndrome)

Answer 10

Chiari type II malformation: Chiari type II malformations are complex developmental disorders of the posterior brain that can be associated with closure defects of the neural tube, myelomeningocele, and dysgenesis of the corpus callosum. • Chiari type III malformation: Chiari type III malformations have the same characteristics as Chiari type II malformations but are associated with encephalocele instead ofmyelomeningocele. • Medulloblastoma: Medulloblastomas are malignant primitive neuroectodermal tumors of the posterior fossa thatarise from the roof of the 4th ventricle. They can be similar to Chiari type II malformations, as they efface the 4th ventricle and can be isointense to the cerebellum on T1-weighted noncontrasted images. Contrast helps to differentiate them, as more than 90% of medulloblastomas enhance.

Answer 11

Skull: lacunar skull; concave clivus; low-riding torcula; wide foramen magnum and upper cervical canal • Dura: fenestrated falx causing interdigitating sulci; heartshaped incisura; hypoplastic cerebellar tentorium • Posterior fossa: towering cerebellum; downward vermian displacement; slitlike 4th ventricle; tectal beaking; wrapping of cerebellum around brainstem; medullary kink • Other common associated defects: myelomeningocele (90%); dysgenesis of the corpus callosum (85%); hydrocephalus (75%); syringomyelia (50%); aqueductal stenosis (50%); holoprosencephaly; tethered cord

Answer 12

Agenesis of the corpus callosum, migration anomalies, cephalocele, holoprosencephaly, hydrocephalus, and porencephaly, among others

Answer 13

Cerebellar atrophy: the cerebellum is small and the cerebellar fissures are enlarged. • Cerebellar hypoplasia: the cerebellum is small, but the fissures are normal in size compared with the folia. • Cerebellar dysplasia: disorganized development; an abnormal folial pattern ranging from absence of fissures to large folia with shallow fissures to foliation in abnormal directions or heterotopic nodules of gray matter may be present. • Cerebellar hypogenesis: the superior portions of the cerebellum are formed, but the inferior portions are not; this term should not be used because it overlaps with dysplasia

Answer 14

Bundles of Probst: tracks of white matter that run parallel to the ventricle as an alternative to the CC • High-riding 3rd ventricle • Absent cingulate sulcus with radially oriented fissures • Crescent-shaped lateral horns; small (“bullhorns”) appearance of the frontal horns • Enlarged occipital horns (colpocephaly) • Absence of the septum pellucidum or severe widening of the cavum septum pellucidum • The precursors of the CC develop between 8 and 20 weeks. Many different genes control the movement of axons across the midline, and numerous mutations can result in callosal defects.

Answer 15

Autosomal-recessive condition, most common in Ashkenazi Jews • Deficiency of aspartoacylase • Hypotonia, macrocephaly, and seizures in newborn period • Spasticity, optic atrophy, and intellectual failure as disease progresses • Death usually by second year of life • Computed tomography: diffuse low attenuation in cerebral and cerebellar white matter • MR imaging: White matter has high T2 and low T1 signal. The thalami and basal ganglia can be affected. • The peripheral white matter is preferentially affected early in the course of the disease. • In severe cases, there may be an extensive lack of myelination with relative sparing of the internal capsules.

Answer 16

There are two types of pericallosal lipomas: bulky (tubulonodular), which are associated with agenesis of the corpus callosum, and ribbon-like (curvilinear).

Answer 17

Hemorrhage ◦ Early subacute (3–7 days): intracellular methemoglobin ◦ Late subacute (7–14 days): extracellular methemoglobin • Lesions with a high protein content • Melanin • Lipids • Minerals (manganesium) • Slow flow

Answer 18

interhemispheric (40–45%), suprasellar-infundibular (25%), quadrigeminal cistern (25%), and CPA (14%)

Answer 19

``` Type I (classic) lissencephaly: Type I lissencephaly is a migration disorder of the gray matter, with the formation of a smooth, four-layered cortex (a normal cortex has six layers). Type I lissencephaly may be isolated or part of a syndrome, most frequently Miller-Dieker syndrome. • Type II lissencephaly (cobblestone complex): ``` Type II lissencephaly has a disorganized, unlayered cortex and no ribbons of band heterotopia. Neurons migrate past the cortical plate to the subpial space. No subependymal heterotopia should be present. Type II lissencephaly is associated with congenital muscular dystrophy (Walker-Warburg syndrome). Ocular defects are common

Answer 20

Three types • Subependymal ◦ Normal development; seizures ◦ Smooth, ovoid masses isointense to gray matter in all sequences • Focal subcortical ◦ Motor and intellectual disturbance, epilepsy ◦ Large heterogeneous mass, isointense to cortical gray matter ◦ The affected hemisphere is small with thin cortex and shallow sulci . ◦ Associated hypogenesis of the corpus callosum and dysplastic basal ganglia Band (laminar) heterotopia • Considered a mild form of classic lissencephaly • Variable developmental delay and seizures • Female preponderance (90%) • Homogeneous bands of gray matter between the lateral ventricles and cerebral cortex, separated from both by a layer of normal-appearing white matter • May have foci of high T2 signal in the white matter

Answer 21

Concomitant anomalies are polymicrogyria outside the cleft, white matter volume loss, septal and optic anomalies, callosal anomalies, and hippocampal anomalies

Answer 22

Associated with schizencephaly: usually, a remnant of the septum pellucidum is present. • White matter hypoplasia, including optic radiations. There is no schizencephaly. Hypopituitarism may be present.

Answer 23

NF1 is a chromosome 17 abnormality. • Spinal NF1 is associated with dural ectasia, lateral meningoceles, and posterior scalloping of the vertebral bodies. • NF1 is also associated with the following: • Plexiform neurofibromas • Optic gliomas (30%) • Osseous dysplasias • Skin findings (café au lait spots, freckling, skin neurofibromas)

Answer 24

A defect in the NF2 gene on chromosome 22q11 is inherited in an autosomal-dominant fashion. • Intracranial lesions include vestibular schwannomas (in 95% of adults, they occur in the internal auditory canal or porus acusticus); multiple meningiomas; and calcifications of the choroid plexus, cerebellar cortex, and occasionally cerebral cortex. • Spinal lesions include cord ependymomas, multiple schwannomas of exiting nerve roots, and meningiomas

Answer 25

The VHL gene on chromosome 3 is inherited in an autosomal-dominant fashion. • Central nervous system (CNS) neoplasms include hemangioblastomas in the cerebellum, brainstem, spinal cord, and retina as well as endolymphatic sac tumors. • Non-CNS lesions include clear cell renal carcinoma, pheochromocytoma, pancreatic neuroendocrine tumors, and epididymal cystadenoma. • Hemangioblastomas are solid, cystic, hemorrhagic, or mixed. They are frequently cystic with a mural enhancing nodule. • Hemangioblastomas may have flow voids from feeding arteries

Answer 26

Type 1 (with septum): 25% ◦ A bony septum results in separate dural tubes, each containing a hemicord. ◦ The usual location is the thoracic or lumbar spine. ◦ Scoliosis is present. ◦ Hydromyelia is common. • Type 2 (without septum): 75% ◦ There is no bony spur; a fibrous septum may be present. ◦ Only one thecal sac contains both hemicords.

Answer 27

This is a tumor of glial origin presenting as a mass in the cortex or subcortical white matter with coarse calcification (20–90% of cases) and occasional cystic degeneration or hemorrhage. Most do not enhance, but there may be subtle enhancement in 20%. They are more frequently supratentorial in location (90% of cases). Vasogenic edema is uncommon

Answer 28

DNETs are benign, well-demarcated cortical lesions. They present as partial seizures in patients younger than 20 years. They occur more frequently in the temporal lobe (60%) or frontal lobe (30%). Cortical dysplasia is often noted adjacent to the lesion. Calcification is rare (20%). DNET appears as a multilobulated “bubbly” lesion with high signal on T2WIs and low signal on T1WIs. There is no surrounding vasogenic edema. Thirty percent show enhancement

Answer 29

* \>10mm at birth * \>3mm at 2 years * \>2mm at 3 years

Answer 30

* Osteogenesis inperfecta * Hypophosphatasia * Rickets * Hypothyroidism * pyknodystostosis * cleidocranial dysplasia

Answer 31

* Hypoparathyroidism * lead intoxication * Abnormal vitamin A

Answer 32

* Neuroblastoma * leukaemia * Lymphoma

Answer 33

* Secondary causes * Haematologic * Sicke cell * Thalassemia * Metabolic * Rickets * hypercalcaemia * hypervitaminosis D * Bone dysplasia * Hypophosphatasia * achrondoplasia * metaphyseal dysplasia * mongolism * Huler disease * skull hyperostosis * Rubinstein-Taybi syndrome * Syndromes * Crouzon * Apert * Carpenter * Treacher Collins * Cloverleaf skill * craniotelencephalic dysplasia * arrhinencephaly * Microcephaly * Post shunting

Answer 34

* Pyknodystostosis * Osteogenesis imperfecta * Rickets (healing phase) * Kinky hair syndrome * CLeidocranial dysostosis * Hypothyroidism/hypophosphatasia * Otopalatodigial syndnrome * Primary oacroosteolysis - Hadju Cheyney/Pachydermiperostosis/progeria * Syndrome of Down * Idiopathic

Answer 35

* Chronic severe aenaemia * Cerebral atrophy * Englemann disease - skull base * Hyperparathryoidism * Acromegaly * Osteopetrosis

Answer 36

* Meningioma * Fibrous dysplasia * Paget disease * Dyke-Davidoff-Mason syndrome * Hyperostosis frontalis interna

Answer 37

HI NEST * Hereditary spherocytosis * Irion deficiency anaemia * Neuroblastoma * Enzume deficiency (G6PD) * Sickle disease * Thalassemia major

Answer 38

* Obstructive hydrocephalus * Cleidocranial dysostosis * Progeria * Rickets * Osteogenesis imperfecta * Craniolacunia

Answer 39

* Neurofibromatosis * Chronic subdural haematoma * Arachnoid cyst

Answer 40

* Normal variant * Trauma * Infection * Congenital * Benign tumour * Malignancy

Answer 41

* Emissary vein * Venous lake * Fossa lacunae * Parietal foramina

Answer 42

* Surgical burr hole * Leptomeningeal cyst

Answer 43

* Osteomyelitis * Hydatid disease * Syphilis * TB

Answer 44

* Epidermoid/dermoid * NF * Meningoencephalocele * Fibrous dysplasia * Osteoporosis circumscripta of paget's disease

Answer 45

* Haemangioma * Enchondroma * Brown tumour * Eosinophilic granuloma

Answer 46

* Solitary/multiple mets * Multiple myeloma * Leukaemia * Neuroblastoma

Answer 47

HELP MFT HOLE * Haemangioma * Epidermoid/dermoid * Leptomeningeal cyst * Post-op, paget * Metastasis, myeloma * Fibrous dysplasia * TB * Hyperparathyroidism * Osteomyelitis * Lambdoid defect * Eosinophilic granuloma

Answer 48

BAMMAH * Brown Tumour * AVM * Myeloma * Mets * Amyloid * Histiocytosis

Answer 49

TORE ME * TB * Osteomyelitis * Radiation * Eosinophilic granuloma * Metastasis * Epidermoid

Answer 50

M is FOR MARINE * Meningioma * Fibrous dysplasia * Optic flioma * Relapsing haematoma * Metastasis * Aneurysm * Retinoblastoma * Idiopathic * NF * Eosinophic granuloma

Answer 51

A FAN * Aneurysm (ICA) * Fistula (cavernous sinus) * Adenoma (pituitary) * Neurofibroma

Answer 52

* Developmental * Infection/inflammation * Benign * Malignancy

Answer 53

Encephalocele

Answer 54

* Extension from sinus/mastoid infection * Trauma complication * Fungal disease * Sinus/nasopharyngeal sarciod * Radiation necrosis

Answer 55

* Juvenile angiofibroma * Meningioma * Chordoma * Pituitary tumour * Paget disease * Fibrous dysplasia

Answer 56

* Mets: prostate, lung, breast * Chondrosarc * NPA carcinoma * Rhabdomyosarcoma * Perineural tumour spread

Neurology lists Flashcards

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