CNS 1 Flashcards
MC organ affected by congenital birth defects
brain
Causes of microcephaly
fetal alc syndrome, trisomy 18, congenital rubella, congenital HIV
MC cause of hydrocephalus
obstruction of normal CSF flow due to congenital malformations, tumors, hemorrhage, or CNS infx, etc
condition of missing portion of a posterior vertebral body
spina bifida occulta
herniation of meninges but not the spinal cord
meningocele
herniation of meninges and spinal cord
meningomyelocele
elevated ____ is associated with neural tube defects and abd wall defects
AFP
What are the percentages of cerebral palsy occurring during pregnancy, during childbirth, and after birth?
75%, 10%, 15%
T or F
Cerebral palsy is more common in premature infants
T
Intrauterine development of cerebral palsy has been associated with
maternal infections, such as Strep throat and CNS infx
MC type of cerebral palsy
Spastic CP (70-80%)
MC finding on autopsy of newborns and infants with CP? Caused by?
Periventricular leukomalacia. Lack of blood flow
Condition in which astrocytes become activated to protect neurons / repair damage
Gliosis
Viral or bacterial?
A) MC cause of meningitis
B) 2nd MC of meningitis
A) viral infx
B) bacterial infx
MC cause of meningitis A) in neonates B) in infants/children C) in adolescents/adults D) older adults E) 2nd MC in all adults
A) E coli B) N. meningococci C) same D) Strep pneumonia E) N. meningococci
Histo typical of meningococcal meningitis
gram negative diplococcic within a neutrophil. edema and focal inflammation
Waterhouse Friderichsen syndrome
complication of meningococcal meningitis
Possibly first symptom of meningococcal meningitis
rapidly spreading petechial rash. numerous small irregular purple or red spots on trunk, LE, mucous membr, conjunctiva, palms, soles
Type of meningitis that occurs most frequently from 1 month to 4 years of age
H flu
Multiple gestation, placental abruption, and fetal abnormalities are associated with what marker? High or low?
High MAFP
Down’s syndrome and Trisomy 18 are associated with what marker? High or low?
Low MAFP
% of children with congenital heart disease that have developmental deficits and brain injury
one third
Children with Periventricular Leukomalacia are at risk for
motor disorders esp of lower limbs
inflammation of pia and arachnoid
meningitis
inflammation of the brain
encephalitis
inflammation of brain, pia and arachnoid
meningoencephalitis
Bacterial or non-bacterial?
A) purulent meningitis
B) aseptic meningitis
A) bacterial
B) non-bacterial
Risk factors for meningococcal meningitis
recent exposure to the disease or recent URI
Prior to vaccine, this organism was the MC cause of bacterial meningitis in children under 5
H flu
Risk factors for H flu meningitis
otitis media, sinusitis, pharyngitis, other URI, Hx, FHx, day care, Native American, Eskimos
20% of pts who recover from H flu meningitis have this complication
hearing loss
These 2 organisms account for half of aseptic meningitis cases
coxsackie and echovirus
others: HSV 1 and 2, varicella, rabies, HIV
This organism most often affects people with compromised immune systems (causing meningitis)
Cryptococcal neoformans (yeast)
Dx of cryptococcal meningitis is made by…
India ink stain, CSF culture, Cryptococcus antigen
Viral Meningitis organisms A) MC in spring and summer B) MC in late summer C) MC in spring D) not seasonal
A) arboviruses
B) Enteroviruses
C) mumps and varicella
D) HSV
What is MC cause of viral meningitis (in which the cause is identified)? What is other major cause?
enteroviruses
HSV
Enteroviruses include
coxsackie A and B, echoviruses, and polioviruses
MC cause of sporadic encephalitis
HSV
What type of herpes is responsible for almost all adult cases of herpes meningitis and herpes encephalitis
Type 2
Type 1 is found more commonly in infants though
Gold standard Dx for carcinomatous meningitis
detection of tumor cells in CSF
What types of non-hematological cancers MC metastasize to the CNS?
lung, breast, and melanoma
also can be head and neck, GU and GI tumors
MC histological type of carcinomatous meningitis
adenoma
Cells of carcinomatous meningitis have this growth pattern
Grow in sheet like fashion
MC cerebral symptom of carcinomatous meningitis
HA (in one-third)
MC cranial nerve symptom of carcinomatous meningitis
diplopia (20%)
slender hyphae which may branch at 45% angles
aspergillus
brain abscesses occur more frequently during what time of life?
first 4 decades
MC organism responsible for brain abscesses
Streptococcus (30-50%)
MC responsible for brain abscesses in infants
gram negative organisms
6 MC organisms responsible for brain abscesses in immunocompromised hosts?
M. tuberculosis, N. astroides, aspergillus, candida, Cryptococcus, toxoplasma
Neurocysticercosis is caused by what organism?
pork tapeworm (taenia solium)
MC neuro-parasitic infection in humans
neurocysticercosis
Cysticercosis in humans only develops by this mechanism
ingesting products which are fecally contaminated with T solium eggs results in larvae encysting in the brain
CT of neurocysticerosis shows
multiple, small nodular, and annular areas of abnormal enhancement in brain parenchyma.
