Developmental disorders of the Central Nervous System. Flashcards
To image infants CNS
Crainial US viea the fontanels, available in the first 8019 months after birth.
Vertebral ultrasound can also be performed in the first 2-3 months, perior to the vertebral arch has fully closed.
Spina bifida, Meningocele, Meningomyelocele.
US can detect large lesions, but MRI is best for evaluating damage, white matter or gray matter disorganizaiton.
Germinal matrix hemorrhage in preterm infants, hyperechogenic region of bleeding in the periventricular CNS tissue, can occur up to 28 weeks of gestation, in preterm infant.s
Hydrocephalus - increased CSF, widened ventricles.
Hypoxic ischemic encephalopathy - due to perinatal ischemia or asphyxia. MRI is the best method to evaluate this damage extent.
What is the location of most brain tumors in children under 2 years?
Supratentorial
Where are most brain tumors in children ages 2-10?
Infratentorial
Where are most brain tumors in children after age 10?
Equally supra or tentorial.
What are Chiari malformations?
Type 1: herniation of the cerebellar tonsils through foramen magnum. May also have a medullary kink and brainstem elongation, and syrningomyelia (long spinal cord cyst)
Type 2: Arnold Chiari: Tonsils and Vermis displacement. Often also with hydrocephalus, and with lumbar or lumbosacral myelomeningocele.
Type 3: Same, and also an occipital encephalocele.
Type 4: Significant cerebellar hypoplasia or agenesis.
What developmental malformations are mentioned?
The 4 chiari malformations
Hydrocephalus
Cerebellar agenesis
Spina bifida, meningocele, meningomyelocele, encephalocele
Tethered cord: end point of the spinal cord remains adhered to a lower lumbar vertebrae. Normally at L3 in neonates, and L1 or L2 by 1 year old. Adults, L1.
Syringomyelia: CSF forming a cavity in the spinal cord that is usually long and tube shaped.
What are the myelopathies
White matter damage………………………..
Best seen with T2 MRI in acute active inflammation phase.
In chronic phase its easily seen as demyelination on either one.
Central pontine myelinosis
aka central pontine demyelination
Caused by too-rapid correction of Hyponatremia or Hypoosmolarity of the blood.
Seen best by T2 or FLAIR, where it is a hyperintense lesion.
arachnoiditis
a pain syndrome caused by irritation to the arachnoid membrane, causing inflammation and irritating the surrounding nerves.
Can occur from trauma or epidural drugs and chemical irritation.
Seen by MRI, showing thickened nerve roots and adhesions or scarring around the roots.
Spinal AV malformations
Strong T2 edema signal in surrounding spinal cord, while the lesion itself has no/very low signal. (it is all moving blood)
