neonatal brain 3

Question 1

what is hydrocephalus

Answer 1

progressive dilation of ventricular system

Question 2

3 mechanisms leading to hydro cephalic

Answer 2

Obstruction to CSF outflow
Decreased CSF absorption
CSF overproduction

Question 3

what grades of hemorrhage can cause hydrocephalus

Answer 3

3 and 4

Question 4

what are 3 signs of hydrocephalus

Answer 4

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

Question 5

what can occur later with hydro cephalic

Answer 5

Bradycardia, apnea and increased ICP

thus monitoring is important

Question 6

what is ependymitis

Answer 6

swelling of the ependymal linings of the ventricles.

it will have increased echogenicity

Question 7

infants with progressive hydrocephalus and increased ICP may require

Answer 7

shunt

Question 8

what is done to identify ICP

Answer 8

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

Question 9

does cerebellar hemorrhage have crazy symptoms

Answer 9

no it may be silent and just found out of routine

Question 10

how is cerebral hemorrhage viewed

Answer 10

through mastoid fontanelle

Question 11

normal posterior fossa viewed through

Answer 11

mastoid fontanelle

Question 12

what will hemorrhage appear as

Answer 12

large echogenic space

Question 13

what is periventricular leukomalacia

Answer 13

hypoxic ischemic brain injury

leukomalacia means softening of white tissue

Question 14

common sites of periventricular leukomalacia

Answer 14

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

Question 15

sono appearance of PVL

Answer 15

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

Question 16

long term effects of PVL

Answer 16

cerebral palsy, developmental abnormalities, intellectual and visual impairment

Question 17

appearance of agenesis of corpus callosum

Answer 17

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

Question 18

dandy walker malformation has a spectrum of anomalies affecting

Answer 18

posterior fossa

Question 19

7 anomalies of dandy walker malformations

Answer 19

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

Question 20

most common type of chiari malformation

Answer 20

chiari 2

Question 21

what is chiari malformation almost always associated with

Answer 21

myelomenigocele

Question 22

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

Answer 22

massa intermedia

connects two thalami and crosses the third ventricle

Question 23

several sono appearance of chiari malformation

Answer 23

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

Question 24

coronal plane sign of chiari 2 malformation

Answer 24

bat wing appearance

Question 25

most common intracranial vascular anomaly in neonate

Answer 25

vein of galen malformation

Question 26

what is vein of galen malformation

Answer 26

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

Question 27

what sono signs are seen with vein of galen malformation

Answer 27

cystic structure
turbulent flow
increased systolic and diastolic flow velocities

Question 28

what is holoprosencephaly

Answer 28

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

Question 29

most severe holoprosencephaly

Answer 29

most severe

alobar type are stillborn or die shortly after birth

Question 30

facial defects as a result of alobar holoprosencephaly

Answer 30

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

Question 31

brain defects as a result of alobar

Answer 31

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

Question 32

semilobar brain defects

Answer 32

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

Question 33

intracranial infections torch acronym

Answer 33

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

Question 34

most common intracranial infection

Answer 34

CMV

Question 35

2nd mots common intracranial infection

Answer 35

toxoplasmosis

Question 36

intracranial infections transmit how

Answer 36

via placenta

except herpes is transmitted at birth

Question 37

role of US with intracranial infections

Answer 37

observe Parenchymal calcifications and Lenticulostriate vasculopathy

Question 38

what is seen sono with CMV

Answer 38

non shadowing echogenic foci representing parenchymal calcifications

Question 39

what is seen on sonogram with lenticulostriate vasculopathy

Answer 39

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