40. congenital and neoplastic disorders of cns

Question 1

list the congenital disorders

Answer 1

hydrocephalus 
lyssencephalon 
cerebellar hypoplasia 
chiari malformation 
syringomyelia

Question 2

what is hydrocephalus

Answer 2

abnormal dilation of ventricular system

Question 3

what types of hydrocephalus do we have

Answer 3

compensatory: CSF in space of lost parenchyma
obstructive: flow or absorption is obstructed
congenital: malformation interfering with flow/absorption
aquired: neoplasia, inflammation

Question 4

what is the result of hydrocephalus

Answer 4

CSF accumulation - elevated pressure - neuron loss

Question 5

clinical sign of hydrocephalus

Answer 5

dome shaped cranium, persistent fontanelle
ventrolateral strabismus
seizure, mental alteration, behavior change

Question 6

therapy for hydrocephalus

Answer 6

anti seizure - diazepam etc?
carbonic anhydrase inhibitor - acetazolamide
proton pump inhibitor - omeprazole
(two above decrease pressure and production of csf)
diuretic - mannitol
corticosteroids

Question 7

lyssencephalon

Answer 7

lack of gyro and sulci - smooth brain
thick cerebral cortex
abnormal behavior, learning difficulties

Question 8

cerebellar hypoplasia causes

Answer 8

cat: in utrero infection with feline panleukopenia virus
dog: in utero infection with dog parvo virus

Question 9

cerebellar hypostasia - what diseases can it come together with

Answer 9

lyssencephalon

hydrocephalus (ventricular dilatation)

Question 10

chiari like malformation what is it

Answer 10

short cranium and occipital malformation -> herniation of cerebellum through foramen magnum

Question 11

chiari like malformation symptom, therapy

Answer 11

neck pain, ataxia, paresis, phantom scratching
prednisolone
gabapentin
nsaid

Question 12

syringomyelia - what is it

Answer 12

cavitation of the spinal chord parenchyma
(hydromyelia: dilatation of central canal of spinal cord)
hard to differentiate the two - often call it syringohydromyelia

Question 13

syringomyelia cause, location

Answer 13

occur secondary to cerebellar herniation

usually cervical spinal cord, multifactorial or continuous lesion

Question 14

syringomyelia clinical signs

Answer 14

excessive scratching of ear/neck, ataxia, postural reaction deficit, neuropathic pain

Question 15

spinal neoplasia classification

Answer 15

extradural
intradural-extramedullary
intramedullary

Question 16

spinal neoplasia - most common tumor types

Answer 16

primary vertebral:
fibrosarcoma, osteosarcoma, adenocarcinoma, hemangiosarcoma

secondary tumors:
mammary/prostatic carcinomas, malignant melanoma, metastatic osteosarcoma

epidural tumor: lymphoma, metastatic tumor
intrdural-extramedullary: meningioma, peripheral nerve sheath tumor
intramedullar: astrocytoma

Question 17

spinal neoplasis signs

Answer 17

depend on location
pain
transversal myelopathy

Question 18

treatment of osteolysis

Answer 18

prednisolone, chemo, radiation

surgical: decompression, removal

Question 19

intracaranial neoplasia - tumor types

Answer 19

primary: meningioma, glioma
secondary: hemangiosarcoma

Question 20

intracranial neoplasia - damages

Answer 20

tumor- loss of neurons -> progressive dysfunction

obstructing absorption and flow of CSF

Question 21

intracranial neoplasia - symptoms

Answer 21

depend on location (circling, ataxia, seizures)
behavioral (dementia, aggression)
focal signs (vestibular signs, strabismus, blindness)
ataxia