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OBGYN 1 > C11: Neural Tube Pathology > Flashcards

C11: Neural Tube Pathology Flashcards

1
Q

Where would we see the 4 ventricle when scanning?

A

On the anterior and inferior edge of the cerebellum

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2
Q

How would you angle the probe from the posterior fossa view p the see the 4th ventricle

A

Inferior

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3
Q

What is hydrocephalus

What commonly causes it?

A

An increase in CSF that results in enlargement of the ventricles

Usually due to obstruction long the path of the CSF

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4
Q

What is the most common cranial anomaly

A

Hydrocephalus

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5
Q

What happens in aqueduct stenosis? What does it cause

A
  • CSF can’t flow from the 3rd and 4th ventricle
  • lateral and 3rd ventricles are enlarged
  • 4th ventricle is normal
  • larger ventricles lead to hardly any brain mantel developing

Aqueduct stenosis is a cause of intRAventricular obstruction hydrocephalus

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6
Q

How will the choroid appear w/ aqueduct stenosis

A

Posterior choroid will be dangling

Anterior choroid will be resting on mid line

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7
Q

What does it mean if you can see the 3rd ventricle on US

A

It means that it’s enlarged

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8
Q

What can cause extraventricular obstruction hydrocephalus

A

Spinal bifida
Excess CSF
Dandy walker malformation

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9
Q

How can spinal bifida cause extracellular obstruction hydrocephalus

Which ventricles does it effect

A

CSF can’t flow normally through the spinal canal and backs up into the ventricles

Effects all ventricles

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10
Q

Where do we measure the ventricles

What is the upper limit of normal

A

At the atria or parietal occipital fissure

Upper is 10mm

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11
Q

What should the measurement from the medial ventricle wall to the choriod be?

A

<3mm

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12
Q

What is true hydrocephalus

A

CSF obstruction

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13
Q

What are the true causes of true hydrocephalus

A

Neural tube defect
Aqueduct stenosis
Dandy walker malformations

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14
Q

What is ventriculomegaly

A

Caused by brain atrophy which allows the ventricles more room to expand… NOT DUE TO OBSTRUCTION

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15
Q

If you see hydrocephalus, which view of the brain should you assess

A

The posterior fossa view

Look at cisterna magna and cerebellum to assess for:

  • obliterated cisterna magna
  • deformed cerebellum (banana)
  • lemon sign
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16
Q

When would the lemon sign be seen

A

2nd trimester

17
Q

When does the lemon sign occur

A

Results when cranial contents are pulled towards the spine w/ Arnold chiari II malformations

18
Q

How does the lemon sign appear of US

A

Frontal bones caved in

19
Q

When does the lemon sign disappear

A

In 3rd trimester due to the resulting hydrocephalus from the enlarging ventricles of the blocked CSF

20
Q

Where are the most common places for a neural tube defect

A

Lumbosacral area

21
Q

What type of Arnold chiari do we see on ultrasound

A

Type 2… other types are so lethal that fetus will die very early on

22
Q

The higher up the neural tube defect goes, is this better or worse in terms of deficits of the baby

A

Worse

23
Q

Describe dandy walker malformation. What characteristics should you look for

A
  • enlarged cisterna magna and absent cerebellar vermis
  • cisterna magna communicates w/ the 4th ventricle through the defect in the cerebellum (absent vermis)
  • ventricles can be enlarged due to pressure in the posterior fossa
24
Q

What is a dandy walker variant

A

Partial agenesis of the vermis w/ smaller cisterna magna and minimal dilation of the ventricles

-associated w/ many syndromes

25
Q

What is DWM associated w/

A

-Intellectual impairment and fetal death

  • agenesis or corpus callosum
  • heart defects
  • genitourinary defects
  • polydactyly
26
Q

The risk of DWM increases w/ what 3 things?

A

Maternal viral infection
Alcohol consumption
Maternal diabetes (type 1 only)

27
Q

What’s the differential diagnosis for DWM and how does it appear

A

Arachnoid cyst in posterior fossa

-fluid collection in the layers of the arachnoid membrane

28
Q

What can the nuchal fold be assessed (wks) and why

A

B/w 16-20 wks because babies may have large fat deposits in this are after 20 wks

29
Q

What is acrania

A

Absent skull

30
Q

What is Anencephaly

A

No or destroyed cerebral cortex

31
Q

What is exencephaly

A

Some cerebral cortex but it’s abnormal

May be an early stage of anencephaly

32
Q

Why is it problematic that brain tissue is exposed to amniotic fluid

A

The amniotic tissue is damaged by the amniotic fluid which leads to exencephaly

33
Q

What does acranial lead to?

A

Leads to exencephaly and then anencephaly

34
Q

What are the US features of exencephaly

A 
Facial structures and orbits are present
No skull above the orbits
Polyhydramnios usually baby can’t swallow)
Active fetus
Frog like face
35
Q

Exencephaly can’t be diagnosed before how many wks

prognosis?

A

12-13 wks

fatal

37
Q

Can you still have a normal CRL w/ anencephaly?

A

Yes

OBGYN 1 (24 decks)

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