Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatric and Superficial Structures > Neonate Brain Pathology > Flashcards

Neonate Brain Pathology Flashcards

1
Q

What is the space that contains CSF between the frontal horns of the lateral ventricles?

A

CSP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the posterior extension of the CSP seen in premies known as?

A

Cavum vergae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Is Cavum Veli Interposti (CVI) a normal variant?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does the CSP close?

A

6-8 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When does the CSP begin to close?

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When imaging the CVI, what should you differentiate it from and how?

A

A vein of galen aneurysm and use color doppler to determine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Widely spaced sylvian fissures are a marker of what?

A

Extreme prematurity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

When should we expect to see sulci on ultrasound?

A

26 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

At what gestational age is the insula fully exposed and sylvian fissures are wide open?

A

Before 24-26 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the other names for prominent periventricular blush?

A
  1. Periventricular halo
  2. Peri-trigonal blush
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the artifact called that is “increased echogenicity in the brain parenchyma around the peri-trigonal area of the ventricles?”

A

Anisotropy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When scanning through the anterior fontanelle, you see periventricular blush. What additional window should you look to confirm true blush or if its just artifactual?

A

Posterior fontanelle will confirm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

If from the posterior fontanelle, we see increased echogenicity within the peri-trigonal area, what abnormality should we suspect?

A

Periventricular leukomalacia (PVL)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Are the lateral ventricles typically larger or smaller in preterm babies?

A

Larger in premies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When ventricular asymmetry is seen, which side of more often larger?

A

Left is often larger than the right

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

At the level of what landmark are connatal cysts/coarctation of the ventricle usually seen?

A

Foramen of Monroe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the name for a fold of the frontal horn of the lateral ventricle and is a normal variant?

A

Connatal cyst/ coarctation of the ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is one of the main indications for neonatal brain U/S?

A

Intracranial Hemorrhage (ICH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

When do brain bleeds typically occur?

A

Within the first few weeks of life (majority within the first 3 days) in a premature baby

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What age and weight of premies are MOST at risk of ICH?

A

<32 weeks gestation and <1500g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

T or F? There is treatment for ICH

A

FALSE: no treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What consists of loosely arranged proliferating cells that give rise to neurons and glia of the cerebral cortex and basal ganglia?

A

Germinal matrix - gives rise to gray matter later on

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where does the GM develop?

A

Below ependymal lining of the ventricles, near foramen of Monroe, and caudate nucleus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The GM contains a network of?

A

Immature, fragile blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Hemorrhage of the germinal matrix typically occurs at how many weeks? (hint: range)

A

24-30 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

GM hemorrhage has a low risk after how many weeks?

A

32

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the most prominent portion of the GM?

A

Caudothalamic groove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where do MOST bleeds originate in the brain?

A

Caudothalamic groove

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

T or F? A normal germinal matrix can be seen on ultrasound?

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is a grade 1GM hemorrhage known as?

A

Subependymal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the mildest form of GM-IVH

A

Grade 1: Subependymal - has NO neurological effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a grade 2 GM-IVH?

A

When a GM hemorrhage ruptures through the ependymal lining and enters into the ventricle with NO ventricular dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How can you determine a clot vs a bulky echogenic choroid plexus?

A

Colour doppler with show some vascularity within the choroid but is absent with a clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

If you see an echogenic area within the frontal or occipital horns of the lateral ventricles, is it most likely a clot or an extension of the choroid?

A

Most likely a clot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

In a grade 2 GM-IVH, where does blood usually accumulate?

A

Occipital horn - most dependent portion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

When the lining of the ventricles become thick/echogenic after a bleed, what is the irritation termed?

A

Chemical ventriculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is a grade 3 GM-IVH?

A

Extension of blood into DILATED ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What grade of hemorrhage is termed “echogenic cast” (blood filling ventricles) of the ventricle?

A

Grade 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is a common complication of grade 3 GM-IVH?

A

Post-hemorrhagic hydrocephalus (PHH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What structure is seen when the 3rd ventricle is dilated that connects the 2 thalami and could be mistaken for a clot?

A

Massa intermedia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

When can the massa intermedia be seen?

A

When the 3rd ventricle is dilated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What pathology is considered to be a result of venous infarction and subsequent hemorrhagic necrosis of the periventricular white matter?

A

Grade 4 - intra-parenchymal hemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

In what lobes are intra-parenchymal hemorrhage IPH most common?

A

Frontal and parietal lobes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What may develop on grade 4 IPH due to clot resorption?

A

Porencephaly - replaces brain tissue over time

43
Q

What grade(s) of hemorrhage have long term neurologic effects?

A

Grade 4

44
Q

What kind of neurological effects can occur due to hemorrhage? (3)

A
  1. Cerebral palsy
  2. Developmental delays
  3. Seizures
45
Q

What is a destructive process where fluid-filled spaces replace brain parenchyma?

A

Porencephaly - due to grade 4 hemorrhage

46
Q

What is the difference between hydrocephalus and ventriculomegaly?

A

Hydrocephalus = ventriculomegaly + increased intra-cranial pressure (ICP)

Ventriculomegaly = dilated ventricles WITHOUT increased pressure

47
Q

With an increase in intra-cranial pressure, what may be the outcome? (3)

A
  1. Blood flow obstruction
  2. Destroys brain cells
  3. Cause herniation
48
Q

What denotes hydrocephalus?

A

Increased volume of CSF with increased ICP

49
Q

What are the 3 types of hydrocephalus?

A
  1. Intra-ventricular obstructing hydro (IVOH)
  2. Extra-ventricular obstructing hydro (EVOH)
  3. Choroid plexus papilloma
50
Q

Pair IVOH and EVOH with communicating vs non-communicating

A

IVOH - non communicating - WITHIN ventricles

EVOH - communicating - OUTSIDE ventricles

51
Q

Where is the most common site for IVOH?

A

Aqueduct of sylvius- because it is the narrowest part and is more prone to obstruction

52
Q

What are the 3 main reasons for an increase in CSF?

A
  1. Obstruction (IVOH/EVOH)
  2. Decreased absorption due to arachnoid villi becoming obstructed
  3. Over production - congenital
53
Q

What are the main signs and symptoms of hydrocephalus?

A
  1. Increased head size
  2. Bulging anterior fontanelle
54
Q

What is NOT a symptom of hydrocephalus?

a. Separation of cranial sutures
b. Increased ICP
c. Tachycardia
d. Apnea

A

C - tachycardia is NOT. Bradycardia is a symptom.

55
Q

What is a treatment for increased ICP?

A

Ventriculoperitoneal shunt (VP)

56
Q

What is a common feature on a spectral waveform to see when a baby has increased ICP?

A

Diastolic flow reversal in the anterior cerebral artery (ACA) - with or without compression

57
Q

What is a common feature on a spectral waveform to see when a baby has increased ICP?

A

Diastolic flow reversal in the anterior cerebral artery (ACA) - with or without compression

58
Q

When you see hydrocephalus, you must report the ventricular index (VI) and anterior horn width (AHW) in mm. At what level of the brain do you measure and how are the measurements taken?

A

Measured at the level of the foramen of Munroe.

VI - measure from the IHF all the way to the edge of the ventricle

AHW - inner to inner measurement of the ventricle - AP measurement

59
Q

What fontanelle is best for visualizing cerebellar hemorrhage?

A

Mastoid fontanelle

60
Q

What is a common cause of brain injury in neonates?

A

Hypoxic-ischemic encephalopathy

61
Q

What abnormalities encompass hypoxic-ischemic encephalopathy?

A
  1. PVL
  2. Traumatic brain injury/brain death
62
Q

What is the most common hypoxic-ischemic brain injury in premies?

A

PVL - necrosis or softening of the white matter of the brain

63
Q

What abnormality is known as the infarction and necrosis of the periventricular white matter?

A

PVL

64
Q

What areas are most affected by PVL?

A
  1. Peri-trigonal area
  2. Anterolateral to the frontal horns
65
Q

T or F? PVL is almost always bilateral and symmetric?

A

TRUE

66
Q

What abnormality usually co-exists with PVL?

A

GMH/IVH

67
Q

What is the early SF of PVL?

A

Increased echogenicity surround ventricles - almost like normal blushing

68
Q

What is the later SF of PVL?

A

Cyst formation without communication within the ventricles

69
Q

The cystic spaces in PVL represent areas of what?

A

Necrosis and cavitation

70
Q

What is the key difference between cysts due to PVL and porencephalic cysts from IPH?

A

Cysts due to PVL - NO communication with ventricle

Porencephalic cysts due to IPH - connected to the ventricles

71
Q

The cystic stage in PVL is the most obvious how long after injury?

A

2-3 weeks after injury

72
Q

Why is MRI better for the later follow-up of PVL?

A

Gliosis fills the cystic spaces over time and can make the parenchyma look normal on ultrasound

73
Q

What are the two most common extra-axial fluid collections in neonates?

A

Subarachnoid

Subdural

74
Q

What are common causes of subarachnoid and subdural fluid collections?

A

Subarachnoid - can be due to macrocrania and in former premies

Subdural - usually a blood collection due to trauma (possibly child abuse)

75
Q

What sign determines a subarachnoid fluid collection and not subdural?

A

Cortical vein sign - vessels crossing subarachnoid spaces

76
Q

What are extra-axial fluid collections related to birth trauma? (3)

A

Cephalohematoma - confined within periosteal layer and cannot spread

Caput Succedaneum - Most superficial and just below the skin

Subgaleal hematoma - Above the periosteum and below aponeurosis

77
Q

What fluid collections can and cannot cross sutures?

A

Cephalohematoma - cannot

Subgaleal hematoma - can

78
Q

Which form of hematoma in the cranium is most serious?

A

Subgaleal hematoma - can cross sutures and cause more complications

79
Q

At what gestation age does the corpus callosum form?

A

3-4 months

80
Q

At what gestation age does the corpus callosum form?

A

3-4 months

81
Q

In partial agenesis, what portion of the corpus callosum will be missing?

A

Posterior aspect

82
Q

What are the SF of corpus callosum agenesis?

A
  1. Lateral ventricles are widely displaced - far apart
  2. Teardrop shape of the lateral ventricles (colpocephaly)
  3. “Sunburst sign” - radial arrangement of sulci and gyri above 3rd ventricle
  4. Complete or partial absence of the hypoechoic midline band above the 3rd and 4th ventricle
  5. Abnormal or absent pericallosal artery
83
Q

What pathology shows the “sunburst sign”?

A

Agenesis of CC - radial arrangement of sulci and gyri above 3rd ventricle

84
Q

What is the term for a spectrum of anomalies of the posterior fossa?

A

Dandy-Walker complex

85
Q

Which dandy-walker complex anomaly has hydrocephalus 80% of the time?

A

Dandy-walker malformation

86
Q

What are the main SF of dandy-walker malformation? (4)

A
  1. Elevated tentorium
  2. Cystic dilation of 4th ventricle
  3. Partial or complete absence of vermis
  4. Small cerebellar hemispheres
87
Q

What are the main SF of dandy-walker variant?

A
  1. Slightly to mod enlarged 4th ventricle
  2. Variable hypoplasia of vermis
  3. Normal cerebellar hemispheres
  4. NO hydrocephalus
88
Q

What part of the brain is involved with Chiari Malformation?

A

Hindbrain/posterior fossa

89
Q

What is the most common type of Chiari malformation?

A

Type 2 - usually ALWAYS associated with myelomeningocele

90
Q

What are the SF of Type 2 Chiari malformation?

A
  1. Small posterior fossa
  2. Downward displacement of cerebellum, medulla, and 4th ventricle - cannot visualize CM
  3. “Bat-wing” appearance - Inferior pointing of the frontal horns of lateral ventricles
  4. Hydrocephalus with prominent massa intermedia
  5. Colpocephaly
  6. Partial or complete absence of CC
91
Q

What is the most common intracranial vascular anomaly presenting in the neonatal period?

A

Vein of Galen Malformation (VGM)

92
Q

What is the VGM? What arteries feed the malformation?

A

Midline cerebral AVM causing dilation of the vein of galen. Anterior and posterior cerebral arteries feed.

93
Q

What are the main signs and symptoms of VGM? (2)

A
  1. Bruit
  2. CHF
94
Q

SF of VGM?

A
  1. Anechoic to hypoechoic midline mass posterior to 3rd ventricle
  2. Turbulent flow of vein of galen - increased flow velocity and dampened pulsatility
95
Q

What part of the brain involves holoprosencephaly?

A

Forebrain/prosencephalon

96
Q

What pathology is known as the failure of the developing forebrain to divide into 2 separate
cerebral hemispheres?

A

Holoprosencephaly

97
Q

What are the 3 main types of holoprosencephaly?

A
  1. Alobar - worst
  2. Semi-lobar
  3. Lobar
98
Q

Many midline craniofacial anomalies are associated with what pathology?

A

Holoprosencephaly

99
Q

SF of alobar holoprosencephaly?

A
  1. Fused thalamus
  2. Absence of CC, IHF, 3rd ventricle
  3. Midline monoventricle
100
Q

SF of semi-lobar holoprosencephaly

A
  1. Single lateral ventricle (Occipital and temporal horns may be formed)
  2. Small portion of the falx may be present
  3. Variable degrees of fusion of thalami
  4. 3rd vent is small or absent
101
Q

SF of lobar holoprosencephaly?

A
  1. Fused frontal horns of the lateral ventricles
  2. Wide communication with the third ventricle
102
Q

What are the most common neonatal infections?

A

TORCH

103
Q

What is a common finding with neonatal infections?

A

Brain calcifications

104
Q

What is Lenticulostriate vasculopathy?

A

Linear branching of echogenic foci in thalamus/basal ganglia - NOT related to TORCH infections

105
Q

What artery in the COW (circle of willis) supplies most of the blood to the brain?

A

MCA

106
Q

What is the best window to access the circle of willis (COW)?

A

Transtemporal window

107
Q

What window is best to view the ACA, pericallosal A, and MCA?

A

ACA and pericallosal - anterior fontanelle

MCA - Transtemporal

Pediatric and Superficial Structures (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions