congenital disorders II

Question 1

where is conus medullaris found at?

progression at 3 months and adult

Answer 1

L3 vertebral body in newborn

rises to L2 vertebral body by 3 months

adult = conus at L1-L2

Question 2

many of congential NTD lead to __

Answer 2

tethering of cord –> so conus medullaris not allowed to rise during development

–> tension on cord (compromises blood supply)

Question 3

possible complications from tension on cord

Answer 3

UMN injury

urinary incontinence

Question 4

symptoms from syringomyelia or tethering on cord

Answer 4

pain or UMN syndrome from tension on cord

urinary incontinence assoc with nerve fibers so urinary function compromised

Question 5

describe syringomyelia

• effect on cord
• symptoms

Answer 5

CSF filled cyst breaks out of central canal of cord and dissects into cord

dysfunction of gray or white matter

ipsil UMN loss
ipsil loss of fine touch and vibration
contralat loss of pain and temp

Question 6

if syringomyelia’s syrinx (CSF cyst) only dissects anterior white commissure

Answer 6

deficits in pain and temp

Question 7

syringomyelia oftne assoc with

Answer 7

chiari 1 malformation

Question 8

causes of perinatal strokes

Answer 8

genetic/malformation

trauma

Question 9

genetic causes of perinatal strokes

Answer 9

vascular/cardiac
neurocutaneous syndromes
sickle cell
polycythemia
clotting problmes

Question 10

trauma causes of perinatal strokes

Answer 10

birth trauma from unusual presentations causing infant neck to be abnormally distorted during birth

Question 11

mechanism of trauma causing perinatal stroke

Answer 11

stretching of carotid artery compromise blood supply to brain (watershed zone) around ACA, MCA, PCA

Question 12

after stroke patients develop

Answer 12

ulegyria (unaffected gyri overgrow infarcted) –> cerebral palsy with weakness, hypertonia, cog impairment

Question 13

what happens if stroke in birth trauma for pre-term infant

Answer 13

before 32-34 weks infants have highly vascular subependymal germinal matrix forming neurons and glia

causes hemorrhage into matrix (gemrinal matrix hemorrhage)–> cerebral palsy

Question 14

germinal matrix hemorrhages most common cause of ___

risk factors

grading?

treat with

Answer 14

cerebral palsy

risk factors = hypercapnia, low birth weight, acidosis, coag

Papile grade 4 = lowest survival

treat with vitamin E

Question 15

describe porencephaly

Answer 15

large unilateral holes due to vascular-ischemic injury

Question 16

describe hydraencephaly

Answer 16

destruction of tissue of one entire hemisphere due to vascular-ischemic injury

Question 17

describe schizencephaly

Answer 17

bilat symmetric holes due to vascular ischemic injuries