Neuro Flashcards
1
Q
How many layers is the cortex?
A
6
2
Q
How many layers is the hippocampus?
A
3
3
Q
What part of the brain is the last part of myelinate?
A
subcortical white matter
4
Q
What parts of the brain are myelinated at birth?
A
brainstem, posterior limb of the internal capsule
5
Q
The sinuses form in what order?
A
maxillary, ethmoid, sphenoid, frontal
6
Q
What goes through the foramen ovale?
A
V3, accessory meningeal artery
7
Q
Foramen rotundum?
A
V2
8
Q
SUperior orbital fissure?
A
CN 3, 4, V1, 6
9
Q
Inferior orbital fissure?
A
CN V2
10
Q
Foramen spinosum?
A
middle meningeal artery
11
Q
Jugular foramen pars nervosa?
A
CN 9
12
Q
Jugular foramen pars vascularis?
A
CN 10, CN 11
13
Q
What is the tympanic branch of the CN9?
A
Jacobsons nerve
14
Q
What is the auricular branch of CN 10?
A
arnolds nerve
15
Q
What goes through the cavernous sinus?
A
CN3, 4, V1, V2, CN 6 carotid
16
Q
What are the branches of the external carotid?
A
Some Adminstrative assistants like fucking over poor medical students.
superior thyroid ascending parhyngeal lingual facial occipital posterior auricular maxillary superficial temporal
17
Q
Its origin is at the dural ring?
A
C6-opthalmic=supraclinoid
18
Q
What is the most common vascular variant?
A
fetal origin of the PCA
19
Q
What is the orientation of the PCOM to CN3 in fetal PCA?
A
superior lateral to CN 3 instead of superior medial
20
Q
What is an aberrant carotid artery?
A
enlarged inferior tympanic artery anastomosis with an enlarged caroticotympanic artery
21
Q
What does the vein of trolard connect?
A
superficial middle vein to superior sagittal sinus
22
Q
What does the vein of labbe connect?
A
superficial middle vein and the transverse sinus
23
Q
CN3 palsy think what kind of aneurysm?
A
PCOM
24
Q
CN 6 palsy think what ?
A
increased ICP
25
What does intracranial hypotension look like?
distention of dural sinuses, prominence of the intracranial vessels and engorgment of intracranial vessels, engorgement pituitary
26
idiopathic intracranial hypertension pseudotumor cerebri
slit like ventricles, pituitary shrinks, venous sinuses compressed
27
upward bowing of the corpus callosum
normal pressure hydrocephalus
28
What nerve gets compressed in descending transtentorial herniation?
CN3
29
What is kernohans notch?
midbrain on tentorium leads to ipsilateral hemiparesis
30
spinning top=
ascending transtentorial herniation
31
What does osmotic demyelination look like?
T2 bright in ncetral pons
32
contrast enhancement of the mamillary bodies=
wernickes
33
Flair signal in bilateral thalamus and periaqueductal gray=
wernickes
34
carbon moxide poisoning on ct and mri?
hypodense, T2 bright GP
35
marchiafava bignami?
swelling/t2 bright corpus callosum
36
sandwhich sign=
marchiafava bignami
37
Methanoal poisoning on MRI
optic nerve atrophy, hemorrhagic putaminal and subcortical white matter necrosis
38
mineralizing microangiopathy=
post chemo in kids
39
What is disseminated necrotizing leukoencephalopathy??
severe white matter changes, demonstrating ring enhancement
40
hippocampal atrophy=
alzheimers
41
dementia with lewy bodies on pet brain?
decreased uptake in lateral occipital cortex with sparing of the mid posterior cingulate gyrus (cingulate island sign)
42
what is binswanger disease?
subcortical leukoencephalopathy, sparing subcortical u fibers
43
picks dementia on fdg pet
low in frontal lobes
44
periventricular calcifications=
CMV
45
CMV has highest association with what?
polymicrogyria
46
Appearance of toxo?
BG calcs and hydrocephalus
47
neonatal HSV in brain?
thrombus with hemorrhagic infarction
48
Neonatal HIV=
frontal atrophy
49
What is the most common opportunistic infection in patients with AIDS?
toxo
50
What is the most common fungal infection in AIDS?
cryptococcus
51
HIV encephalitis in what CD4 count?
<200
52
HIV encephalitis appearance?
symmetric increased flair in deep white matter, spares subcortical u fibers, T1 normal
53
PML at what CD4?
less than 50
54
PML appearance
T1 hypointense, T2 hyperintense, asymmetric with involvement of the subcortical u fibers
55
Ring enhancing lesion with lots of edema=
toxo
56
edema in temporal lobe=
herpes
57
What is limbi encephalitis?
paraneoplastic syndrome similar to hsv
58
what does west nile look like in the brain
t2 bright BG and thalamus with RD
59
What are the three ways CJD may be shown?
pulvinar sign, restricted cortical gyriform signal. series of CT/MR showing rapid atrophy
60
what is the pulvinar sign?
RD in dorsal medial thalamus
61
What ist he pulvinar sign
RD in dorsal medial thalamus
62
What are the four stages of neurocysticercosis
vesicular, colloidal, granular, nodular
63
What are the two low grade tumors that enhance?
ganglioglioma and pilocytic astrocytoma
64
Mnemonic for bleeding mets?
MRCT: melanoma, rena, carcinoid, choriocarcinoma, thyroid
65
Two tumors found in NF1
optic glioma, astrocytoma
66
NF2 tumors
MSME, mutiple schwannomas, meningiomas, ependymomas
67
Tumors in tuberous sclerosis
subependymal tubers, IV giant cell astrocytomas
68
Mnemonic for cortically based tumors
PDOG
PXA,
DNET
oligodendroglioma
ganglioglioma
69
calcified frontal lobe tumor with cortical expansion
oligodendroglioma
70
temporal lobe mass that is cystic/solid with focal calcifications
ganglioglioma
71
DNET
bubbly temporal lobe lesion
72
PXA
cyst with nodule in temporal lobe- can have dural tail
73
5 tumors that arise from the ventricular wall and septum pellucidum
ependymoma, medulloblastoma, SEGA, subependymoma, central neurocytoma
74
3 choroid plexus tumors
papilloma, carcinoma, xanthogranuloma
75
tooth pastetumor
ependymoma
76
where does ependymoma originate from
floor of fourth ventricle
77
Where does medullobastoma arise from?
vermis/floor of fourth ventricle
78
What posterior fossa tumor can be hyperdense?
medulloblastoma
79
What two syndromes are medulloblastomas associated with?
Turcos, Basal Cell nevus
80
What is gorlin syndrome
medulloblastoma, dural calcs, basal cell skin CA, odontogenic cysts
81
enhancing partially calfied lesion at foramen of monroe over 5mm
SEGA
82
SEGA a/w ?
AML
83
Subependymoma found where?
foramen of monro and 4th ventricle in adult
84
swiss cheese lesion=
central neurocytoma
85
Choroid plexus lesion in kid is hwere?
4th ventricle
86
In adult?
lateral ventricle/trigone
87
Choroid plexus carcinoma a/w?
li fraumeni
88
round well circumscribed mass in anterior 3rd ventricle
colloid cyst
89
Where is an intraventricular meningioma most commonly?
trigone of lateral ventricles
90
Meningioma takes up what radiotracer?
octreotide and Tc MDP
91
Schwannoma or meningioma invade iac?
schwannoma
92
What is the most common location for a dermoid cyst?
suprasellar cistern
93
infratentorial cyst with nodule
JPA
94
diffuse brain stem glioma
pons, t2 bright with flattening of 4th ventrcile
95
hemangioblastoma?
cyst with nodule in adult in cerebellum
96
hemangioblastoma a/w?
polycythemia
97
gliomatosis cerebri
involves three lobes with blurring of grey white matter differentiation
98
what is the most common primary cns lymphoma?
non hodgkin b cell
99
rapidly increasing head circumference =
DIG large cystic tumor supratentorial
100
mimics an aggressive meninigoma
hemangiopericytoma but invades skull
101
what is the most common met to the dura?
breast CA
102
which type of craniopharyngioma is calcified?
adamantinomatous
103
machinery oil=
adamantinomatous craniopharygioma
104
pineal mass encasing calcs
germinoma
105
pineal mass exploding calcs
pineocytoma or pineoblastoma
106
What two tumors are seen in turcots?
GBM, medulloblastoma
107
Cowdens=
lhermitte duclos! breast CA
108
Ossicular dislocation is most common in what temporal bone fracture type?
longitudinal
109
Facial nerve damage is most common in what fracture tyope?
transverse
110
fusiform aneursyms are associated with what three things?
PAN, connective tissue disorder, dysphillis
111
what is a pedicle aneursym
found on artery feeding AVM
112
what is a blister aneurysm
brad based at a non branch point= supraclinoid ICA
113
what is infubdibular widening
origin at PCOM, not greater than 3mm
114
pulsatile tinnitus involving the sigmoid sinus=
dural AVF
115
caput medusae or large tree with multipile branches-
DVA
116
popcorn, peripheral rim of hemosiderin=
cavernoma
117
when does vasospasm occur
4-14 days after hemorrhage
118
what is the most common systemic vasculitis to involve the CNS?
PAN
119
WM diease greatest of frontal and temporal lobes=
CADASIL
120
asymmetric dilation of the occipital horns=
colpocephaly
121
if colpocephaly think 2
pericallosal lipoma and corpus callosum agenesis
122
steer horn ventricles or vertical ventricles=
callsoal dysgenesis/agenesis
123
frog eye appearance=
anencephaly
124
iniencephaly=
deficit of occiput leading to enlarge foramen magnum, star gazing fetus
125
transversely oriented single lobed cerebellum=
rhombencephalosynapsis
126
molar tooth=
joubert syndrome
127
joubert a/w?
retinal dysplasia
128
joubert + liver fibrosis=
COACH syndrome
129
dandy walker=
torcuar lambdoid inversion
130
fused at thalami=
semi lobar holoprosencephaly
131
single lobar ventricle=
alobar no falx
132
meckel gruber syndrome triad
holoprosencephaly, multiple renal cyst, polydactyly
133
schizencephaly a/w 3
optic nerve hypoplasia, absent septum pellucidum, epilepsy
134
hydrancephaly
falx, no mantle
135
brachycephaly + fused fingers=
aperts
136
brachycephaly + first arch hypoplasia=
crouzon
137
bicoronal/lambdoid fusion=
brachycephaly
138
sagital fusion=
scaphocephaly
139
u/l coronal fusion=
plagiocephaly
140
metopic fusion-
trigonocephaly
141
coronal and lambdoid fusion=
turricephaly
142
what is bessi?
benign enlargment of the subarachnoid space in infancy
143
what is the most common cause of macrocephaly?
BESSI
144
what does MELAS look like on spect?
increased lactate, decreased NAA
145
canavans on spect?
increased NAA
146
ALexandrers on head ct?
big head, frontal WHM involvemenbt
147
tigroid=
metachromatic
148
adrenoluekodystrophy territory
occiput, splenium WM symmetric
149
leigh diseease aka
subacute necrotizing encephalomyeloaphty
150
What is the highest normal peak on SPECT?
NAA
151
what is a lactacte peak seen in?
first hourso f life, infection, high grade necrotic tumor
152
what is myoinositol elevated in?
alzheimers, low grade tumors
153
alanine elevation is specific for?
meningiomas
154
glutamine elevated in?
hepatic encephalopathy
155
high grade tumor SPECT
choline up NAA down, lactate and lipis up
156
low grade tumor SPECT
choline naa down, inositol up
157
radiation necrosis spect pattern
choldine naa down, lactate up
158
cholesterol granuloma mr characteristics
t2 and t1 bright
159
cholesteatoma mr characteristics
t1 dark, t2 bright, RD
160
endolymphatic sac tumor on mr
t2 bright with enhanvement. flow voids
161
endolymphatic sac tumor a/w
VHL
162
absence of what is seen in LVAS?
bony modiuls
163
LVAS is most common cause of what?
sensorineural hearing loss
164
what does labyrinthis look like on mr
chochlea semicircular canals enhancing
165
conductive hearing loss in adult femeale
otosclerosis
166
bony resorption anterior to the oval window at teh fissula natefenestrum=
fenestral
167
demineralization around choclea=
retro fenestral
168
otitic hydrocephalus=
venous thrombus affecting resorption of CSF
169
order in which cholestatoma ruins the ear?
sctum, ossicles (long process of incus) lateral semicircular canal
170
main bacteria in necrotizing external otitis?
pseudomonas
171
what parts do NOT enhance of the facial nerve?
cisternal, canalicular, labyrinthine
172
what parts of the facial nerve enhance?
tymapnic, mastoid
173
widening of the maxillary ostium=
antrochoanal polyp
174
classic location of inverrted papilloma?
lateral wall of nasal cavity, middle tubrinate
175
cerebriform pattern on MRI=
inverted papilloma
176
what NM is positive in esthesioneuroblastoma
octreotide
177
what is the main supply to the posterior
sphenopalatine artery branch of internal maxillary
178
sack of marbles=
floor of mouth dermoid/epidermoid
179
submandibular duct=
whartons
180
periapical cyst/radicular cyst located where
apex of non vital tooth
181
dentigerous cyst location where?
crown of un erupted tooth
182
multilocular daughter cystic lesion at mandibular ramus or body=
keratogenic odontogenic tumor
183
multicystic mandibular lesion with solid components and mandibular expansion
adamntioma/ameloblastoma
184
raidodense lesion of jaw with lucent rim
odontoma/hamartoma
185
parotid space contains what three things
partoid gland CN 7 retro mandibular vein
186
What is the most common major and minor salivary gland tumor?
pleomorphic adenoma
187
What does a pleomorphic adenoma look like?
t2 bright with low signal rim
188
Superifical vs deep parotid gland?
line from lateral posterior belly of the digastric and lateral surface of the mandibular ascending ramus
189
bilateral cystic tumor in male smoker
warthins
190
what does warthins tumor take up on nm?
pertechnetate
191
What is the most common malignant tumor of the minor salivary glands
mucoepidermoid carcinoma
192
Perineural tumor spread=
adenoid cystic carcinoma
193
What patients have a huge risk of parotid lymphoma?
Sjogrens
194
honeycombed partoid gland=
sjogrens
195
What nerves are in the carotid space?
CN 9 10 11
196
What are the three classic carotid space tumors?
paragangliom, schwannoma, neurofibroma
197
middle ear floor destroyed=
glomus jugulare
198
tumor overlying the cochlear promontory
glomus tympanicum
199
what is i nthe masticator space?
masticators, mteporalis, medial/lateral ptreygoids, mandibular ramus, inferior alveolar nerve
200
Perineural spread=
adenoid cystic and melanoma
201
what are the lateral nodes of rouvier?
retropharyngeal nodes
202
What is grisels syndrome?
torticollis with anterior disAA join inflammation seen in HN surgery or retropharyngeal abscess
203
anterior displacement of paraphyngreal space=
carotid lesion
204
medial displacement=
partoid lesion
205
posterior medial displacement
masticator space
206
lateral deviation
superifical mucosal space
207
What seaparates 1a from 1 b nodes?
anterior belly of digastric
208
what separates 1 b from 2 a nodes?
stylohyoid muscle/posterior submandibular gldn
209
what separates 2a from 2 b nodes
spinal acessory nerve
210
what separates 2 from 3
lower border of hyoid
211
what separates 3 from 4
lower cricoid
212
Fixation of the cords indicates what?
T3 tumor
213
focal discontinuity of the globe=
coloboma
214
small eye of increased density of the vitreous=
PHPV persistent hyperplastic primary vitreous
215
what is coats disease caused by?
retinal telangiectasis results in subretinal exudate. NOT calcified.
216
tramtrack calcifications of theoptic nerve
optic nerve sheath menigioma
217
orbital pseudotumor painful?
now
218
what does orbital pseudotumor involve?
lacteral rectus most commonly with sparing of myotendinous insertions
219
IgG4 disease involving the cavernous sinus
tool
220
igg4 disease involving the pituitary
lymphocytic hypophysitis
221
what is the most common benign congential orbital mass and what doesit look like?
dermoid superior lateral from frontozygomatic suture
222
WHat ist he most common extra ocular malignancy in kids?
rhabdomyosarcoma
223
Malt lymphoma is a/w?
chlamydia psittaci
224
WHat is the most common intra ocular lesion in an adult?
melanoma
225
collar button shaped eye tumor=
melanmoma
226
Melanoma eye has strong predilection for what kind of met?
liver met
227
What is the most common cause of sponatenous orbital hemorrhage?
varix
228
Two causes of pulsatile exopthalmos?
CCF, NF1 due to sphenoid wing dysplasia
229
What does thyroid orbitopathy affect?
only muscle belly, IM SLOw
inferior rectus>medial rectus>lateral rectus>superior oblique
230
Is thyroid orbitopathy painful?
NO
231
stop coumadin how long before LP?
4-5 days
232
stop lavix how long before LP?
7 days
233
hold LMW heparin how long?
12 hours
234
Hold heparin how long?
2-4 hours
235
WHat is he currarino triad?
anterior sacral meningocele, anorectal malformation, sacrococcygeal osseous defect
236
What is the most common spinal vm/avf
type 1 dural AVF
237
What is a type 2 avf/avm?
intramedullary nidus
238
What is a type three avm/svf
juvenile-rare
239
what is a type 4 spinal avm/avf
intradural perimedullary near conus
240
What is foix alajouanine syndrome
myelopaty a/w dural avf at conus or lower thoracic spine
241
another way t odescfibe H shape vertebrae?
widened disc space
242
bilaterally symetric increased t2 dorsal signal of the ord
scid or HIV
243
Increased t2 of at least 2/3 of cord
TM, NMO, MS iscehmia
244
thickened enhancing onion bulb nerve roots=
chronic inflammatory demyelinating polyneuropahty CIDP
245
what are the three intramedullary tumors?
astrocytoma, ependymoma, hemangioblastoma
246
what are the four extramedullary intradural tumors?
schwannoma meningioma neurofibroma drop mets
247
what are the four extra dural tumors"
disc, bone tumors, mets, lymphoma
248
astorcytoma what age group?
kids
249
where is astrocytoma located?
upper thoracic spine
250
what do astrocytomas look like?
t1 dark, t2 bright with rostral or caudal cysts
251
ependymoma kid or adults?what ist he most common primary cord tumor of the lower spinal cord?
ependymom
252
myxopapillary ependymoma
found in conus/filum with dark cap on T2
253
expanded cord with meningeal varicosities
hemangioblastoma
254
what a re the 6 lesions a/w VHL?
pheo, CNS hemagnioblastoma, endolymphatic sac tumor, pancreatic cyst, pancreatic islet cell tumor, clear cell RCC
255
what section of cord do meningiomas favor?
posterior lateral thoracic spine or anterio cervical spine
