2. Herniation Syndromes

Question 1

Is an umbrella term for a herniation of the cranial contents through a defect in the
skull.

Answer 1

Cephalocele

Question 2

While retaining the suffix “cele” they are then sub-classified based on

Answer 2

(1) location
(2) what is in the herniation sac

Question 3

Location of cephalocele

Answer 3

Occipital - Most classic

Question 4

Herniation sac contents

Answer 4

Question 5

Answer 5

Chiari Type I

Posterior fossa underdeveloped = overcrowding = downward displacement

Sx:
Headache
Weakness

Association:
Syrinx of the cervical Cord

Klippel-Feil Syndrome (Congenital C-spine fusion)

NOT associated with a neural tube defect

Question 6

Answer 6

Chiari Type II

More on Cerebellar vermian displacement

Interdigitated cerebral gyri
Myelomenigocele - lumbar spine + spina bifida

Neural Tube Defect “SUCKS” the cerebellum downward prior to full development of the cerebellar tonsils

ONLY SEEN IN PATIENTS WITH NTD

Question 7

Answer 7

Chiari Type III

Question 8

This is a pattern of findings (hippocampal volume loss + gliosis / scar), which classically result in intractable seizures

Answer 8

MEsial Temporal Sclerosis

Question 9

This is the most common cause of partial complex epilepsy.

Answer 9

Mesial Temporal Sclerosis

Question 10

Primary Imaging findings of Mesial Temporal sclerosis

Answer 10

Reduced hippocampal Volume
Increased T2 Signal (from gliosis/scar)
Loss of normal morphology