neonatal brain 3 Flashcards

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1
Q

what is hydrocephalus

A

progressive dilation of ventricular system

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2
Q

3 mechanisms leading to hydro cephalic

A

Obstruction to CSF outflow
Decreased CSF absorption
CSF overproduction

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3
Q

what grades of hemorrhage can cause hydrocephalus

A

3 and 4

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4
Q

what are 3 signs of hydrocephalus

A

Increasing head size
Bulging of the anterior fontanelle
Separation of cranial sutures

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5
Q

what can occur later with hydro cephalic

A

Bradycardia, apnea and increased ICP

thus monitoring is important

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6
Q

what is ependymitis

A

swelling of the ependymal linings of the ventricles.

it will have increased echogenicity

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7
Q

infants with progressive hydrocephalus and increased ICP may require

A

shunt

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8
Q

what is done to identify ICP

A

a slight pressure is applied to the head with using spectral doppler of pericallosal artery

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9
Q

does cerebellar hemorrhage have crazy symptoms

A

no it may be silent and just found out of routine

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10
Q

how is cerebral hemorrhage viewed

A

through mastoid fontanelle

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11
Q

normal posterior fossa viewed through

A

mastoid fontanelle

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12
Q

what will hemorrhage appear as

A

large echogenic space

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13
Q

what is periventricular leukomalacia

A

hypoxic ischemic brain injury

leukomalacia means softening of white tissue

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14
Q

common sites of periventricular leukomalacia

A

White matter adjacent to peritrigonal area of lateral ventricles
Frontal cerebral white matter anterolateral to frontal horns

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15
Q

sono appearance of PVL

A

Increased echogenicity in affected area
Bilateral and symmetric
Echogenicity should not be > choroid plexus
Difficult to differentiate from periventricular blush
Later changes to PVL
Formation of cysts as a result of necrosis and cavitation

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16
Q

long term effects of PVL

A

cerebral palsy, developmental abnormalities, intellectual and visual impairment

17
Q

appearance of agenesis of corpus callosum

A

Frontal horns widely separated and angled laterally
Occipital horns have parallel orientation and a teardrop* shape
Enlargement of posterior (occ.) horns (colpocephaly)
*
Radial arrangement of sulci and gyri above 3rd ventricle – sunburst sign**
Absent CSP*, high and enlarged 3rd ventricle

18
Q

dandy walker malformation has a spectrum of anomalies affecting

A

posterior fossa

19
Q

7 anomalies of dandy walker malformations

A
Cystic dilatation of 4th ventricle
Superior elevation of the tentorium
Absence of vermis
Small cerebellar hemispheres
Hydrocephalus 
agenesis of CC
holoprosencephaly
20
Q

most common type of chiari malformation

A

chiari 2

21
Q

what is chiari malformation almost always associated with

A

myelomenigocele

22
Q

what is seen when the 3rd ventricle is dilated and what does it connect

A

massa intermedia

connects two thalami and crosses the third ventricle

23
Q

several sono appearance of chiari malformation

A

Hydrocephalus with prominent massa intermidia
Inferior pointing of frontal horns – “bat wing”
Downward displacement of cerebellum and 4th v. into spinal canal
Non-visualized cisterna magna
Small posterior fossa
Low and displastic tentorium
Colpocephaly (large occ. horns)
Complete or partial CC agenesis

24
Q

coronal plane sign of chiari 2 malformation

A

bat wing appearance

25
Q

most common intracranial vascular anomaly in neonate

A

vein of galen malformation

26
Q

what is vein of galen malformation

A

midline cerebral AV malformation that causes dilatation of v. of Galen

Anterior and posterior cerebral arteries feed the malformation

Decreased blood supply to brain – atrophy and calcifications of brain

27
Q

what sono signs are seen with vein of galen malformation

A

cystic structure
turbulent flow
increased systolic and diastolic flow velocities

28
Q

what is holoprosencephaly

A

Spectrum of congenital malformations that result from a disorder of diverticulation in which the primitive forebrain (prosencephalon) fails to divide into two separate cerebral hemispheres

29
Q

most severe holoprosencephaly

A

most severe

alobar type are stillborn or die shortly after birth

30
Q

facial defects as a result of alobar holoprosencephaly

A
Severe facial anomalies
Close set eyes – hypotelorism
Cyclopia
Proboscis – nose on forehead
Cleft lip/palate
31
Q

brain defects as a result of alobar

A
There is a thin pancake like primitive cerebrum covering a horseshoe shaped midline monoventricle
Missing:
Corpus callosum
Third ventricle
Interhemispheric fissures
Thalami are fused
32
Q

semilobar brain defects

A

Incomplete forebrain division with partial separation of the cerebral hemispheres posteriorly
Single ventricle with occipital and temporal horns formed
Falx may be present
3rd v. is small or absent

33
Q

intracranial infections torch acronym

A
T  Toxoplasmosis
O  Others
R  Rubella
C  Cytomegalovirus CMV
H  Herpes Simplex
34
Q

most common intracranial infection

A

CMV

35
Q

2nd mots common intracranial infection

A

toxoplasmosis

36
Q

intracranial infections transmit how

A

via placenta

except herpes is transmitted at birth

37
Q

role of US with intracranial infections

A

observe Parenchymal calcifications and Lenticulostriate vasculopathy

38
Q

what is seen sono with CMV

A

non shadowing echogenic foci representing parenchymal calcifications

39
Q

what is seen on sonogram with lenticulostriate vasculopathy

A

Bilateral branching of echogenic foci in the basal ganglia (these are mineral deposits)