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Neuro Flashcards

1
Q

What is torcular herophili

A

Confluence of sinuses

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2
Q

When do fontanelles close

A

24 months

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3
Q

When is the brain done myelinating

A

9 years old

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4
Q

Def Dyke-Davidoff-Mason

A

Hemi-cerebral atrophy/hypoplasia, compensatory IPSI osseous hypertrophy and Contra hemiparesis

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5
Q

Sign of Asterion is what?

A

Sutural closure of Parietomastoid and occipitomastoid and lamboidal suture

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6
Q

Hyperostosis frontalis interna + Obesity + hirsutism is AKA

A

Morgagni syndrome

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7
Q

Leptomeningeal cyst is formed how?

A

Skull Fx with dural tear, prevents union

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8
Q

Anomalies seen with Chiari 1

A

Klippel-Feil, syrinx, basilar invagination, C0/C1 assimilation

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9
Q

Anomalies seen with Chiari 2

A

Myelomeningocele, syringohydromyelia, scoliosis, tectal beaking

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10
Q

Def Meckel syndrome

A

Holoprosencephly/Occipital encephalocele, renal cystic dysplasia, postaxial polydactyly

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11
Q

Morsier syndrome is AKA

A

Septoopic dysplasia

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12
Q

Def Septo-optic dysplasia

A

Absent septum pellucidum with optic nerve hypoplasia

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13
Q

Def Kallmann syndrome

A

Anosmia/hypoosmia, hypogonadism and mental retardation

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14
Q

Def Walker-Warburg syndrome

A

Ocular malformation, cephaloceles, congenital hypotonia and death within 1 year

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15
Q

What is a porencephalic cyst

A

CSF space lined by glial white matter

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16
Q

Def Dandy-Walker syndrome

A

Cystic dilation of 4th ventricle, enlarged posterior fossa and cerebellar hypoplasia

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17
Q

Def Dandy-Walker variant

A

Mild vermis hypoplasia, cystic space from 4th ventricle widening

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18
Q

L’Hermitte-Duclos dz is what

A

Cerebellar dysplasia, dysplasia ganglioctyoma. Seen with Cowden disease

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19
Q

MC phakomatosis

A

NF1 (Von recklinghausen)

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20
Q

What is a Lisch nodule

A

Pigmented Iris hamartoma seen in NF1 (Not in NF2)

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21
Q

Hallmark tumor of NF1

A

Plxiform neurofibroma

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22
Q

MR signal of a hamartoma

A

High T1, very high T2, no enhancement or mass effect

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23
Q

Hallmark of NF2

A

Acoustic schwannomas

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24
Q

3 common intramedullary lesions of the spine

A

Astrocytoma, Ependymoma and hemangioblastoma

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25
Q

3 common intradural, extramedullary lesions of the spine

A

Meningioma, Schwannoma (MC) and neurofibroma

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26
Q

Classic triad of tuberous sclerosis

A

Papular facial nevus (adenoma sebaceum), Seizures, mental retardation

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27
Q

Cortical tubers are AKA

A

cortical hamartomas

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28
Q

MR signal of cortical tubers in kids and adults

A

Kids (T1 High, T2 Low); Adults (T1 Iso/low, T2 High); only 5% enhance

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29
Q

Tumor ass’d with VHL

A

hemangioblastoma

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30
Q

Hereditary hemorrhagic telangiectasis is AKA

A

Rendu-Osler-Weber syndrome

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31
Q

Rendu-Osler-Weber syndrome lesions include

A

telangiectasia, AVM, fistulas, aneurysms. characterized with nose bleeds (85%)

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32
Q

% of arterial infarcts that are hemorrhagic

A

25%

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33
Q

Lucid interval is ass’d with what hematoma

A

Epidural hematoma

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34
Q

3 MC locations of DAI

A
  1. Gray-white matter junction in frontotemporal
  2. posterior body of the splenium of the corpus callosum
  3. Dorsolateral upper brain stem
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35
Q

2 MC brain herniations

A

Subfalcine - Cingulate gyrus goes under falx cerebri

Inferior/descending transtentorial uncal herniation

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36
Q

Arterial occlusion seen with subfalcine herniation

A

Anterior cerebral artery, esp the pericallosal branch

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37
Q

Arterial occlusion seen with descending transtentorial herniation

A

Posterior cerebral artery, leads to Duret hemorrhage

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38
Q

Def kernohan’s notch phenomenon

A

Indentation of the contralateral cerebral crus by the tentorium due to mass effect. Seen in a inferior/descending tentorial herniation

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39
Q

Early reliable sign of cerebral edema

A

Sulcal effacement

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40
Q

MC traumatic AV fistula

A

Carotid-Cavernous sinus fistula

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41
Q

Pneumocephalus, how does patient position affect in epidural vs subdural location

A

Epidural - No change with pt movement

Subdural - Changes with pt movement

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42
Q

MC cause of CSF fistula

A

Skull base fx

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43
Q

Def Wyburn-mason

A

Multiple retinal, brain AVM with cutaneous nevi

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44
Q

MC parenchymal (pial) AVM

A

85% supratentorial

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45
Q

Multiple venous angiomas are seen in which syndrome

A

Blue Rubber Bleb nevus syndrome

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46
Q

MC brain vascular malformation

A

Cavernous angioma

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47
Q

Common structure involved in hypoxia-ischemic encephalopathy

A

basal ganglia

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48
Q

What artery occlusion would affect the septum pellucidum and anterior 1/3 of the corpus callosum

A

Pericallosal branch from the ACA

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49
Q

Idiopathic Progressive arteriopathy of childhood is AKA

A

Moyamoya

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50
Q

Def Menkes’ Kinky hair dz

A

X-linked neurodegenerative condition with copper metabolism issues

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51
Q

MC bug for bacterial meningitis in kids

A

H. influenza

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52
Q

Syphillitic arteritis is AKA

A

Cerebrovascular lues

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53
Q

MC systemic necrotizing arteritis with CNS manifestations

A

Polyarteritis Nodosa (PAN)

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54
Q

Polyarteritis nodosa affects which vessels

A

Small/medium arteries leading to microaneurysms

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55
Q

MC loc for venous sinus occlusion in the brain

A

Superior sagittal sinus

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56
Q

MC loc for veins in the brain

A

Superior cortical veins

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57
Q

4 categories of glial tumors

A

Astrocytoma, oligodendroglioma, ependymal tumors and choroid plexus tumors

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58
Q

Brain tumors mets or primary more common in adults

A

Mets is more common

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59
Q

Tumors ass’d with tuberous sclerosis

A

Subependymal giant cell astrocytoma (SEGA)

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60
Q

MC loc of ependymal tumors

A

infratentorial; 4th ventricle

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61
Q

Myxoppillary ependymal tumor location?

A

Spinal cord; Filum terminale

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62
Q

MC loc of papillomas in kids vs adults

A

Kids - lateral ventricle

Adult - 4th ventricle

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63
Q

MC primary brain tumor

A

Astrocytoma

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64
Q

2nd primary MC brain tumor

A

Meningioma

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65
Q

Top 2 MC sites of a schwannoma

A

CN8 and CN5

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66
Q

% of brain tumors from mets

A

~33%

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67
Q

MC location of a medulloblastoma

A

Cerebellar vermis - 90%

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68
Q

2 MC posterior fossa tumors in kids

A

Pilocytic astrocytomas and medulloblastoma

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69
Q

2 MC posterior fossa tumors in adults

A

Hemangioblastoma and brain stem glioma

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70
Q

MC non-neoplastic pineal mass

A

Pineal cyst

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71
Q

What % of medulloblastoma are midline

A

90% and can lead to drop mets

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72
Q

Top 2 lesions of the cerebellopontine angle

A

Schwannoma followed by meningioma

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73
Q

Def Gradenigo syndrome

A
  1. Petrous apicitis
  2. Abducens nerve palsy
  3. V1/V2 distribution pain
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74
Q

Paraganglioma by the cochlea is known as

A

Glomus tympanicum

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75
Q

Normal MR signal of pituitary

A

Ant is iso to brain on T1 and T2

Post is high T1, low T2

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76
Q

MC intrasellar mass

A

Microadenoma

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77
Q

Def Sheehan syndrome

A

Postpartum infarct of pituitary leading to empty sella

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78
Q

Size cutoff between micro and macropituitary adenoma

A

10mm

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79
Q

MC benign nasopharyngeal tumor

A

Juvenile nasopharyngeal angiofibromas

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80
Q

MC primary CNS tumor

A

GBM

81
Q

MC supratentorial mass in kids

A

astrocytoma

82
Q

MC location of a pilocytic astrocytoma

A

Cerebellum

83
Q

MC location of pleomorphic xanthoastrocytoma

A

Peripheral temporal lobes - seen with seizures

84
Q

MC loc of SEGA

A

Foramen of Monro - ass’d with tuberous sclerosis

85
Q

Desc a SEGA lesion

A

Partially cystic and calcified lesion, can lead to noncommunicating hydrocephalus

86
Q

MCly calcified intracranial tumor

A

oligodendroglioma

87
Q

MC loc of an oligodendroglioma

A

Cortical frontal lobe region

88
Q

MC loc of a choroid plexus papilloma in kids and adults

A

Kids - trigone of the lateral ventricle

adults - 4th ventricle

89
Q

Desc hemangioblastoma

A

Found in cerebellum of adults, primarly cystic with mural nodule, nodule will +C, lack of hemorrhage, calcification or necrosis

90
Q

MC germ cell tumor

A

Germinoma

91
Q

Age and loc of a germinoma

A

10-30 yo, pineal gland (engulfs it)

92
Q

Age and sex of a teratoma

A

Young, males. 2nd MC germ cell tumor

93
Q

Syndrome ass’d with medulloblastoma

A

Gorlin syndrome (Basal Cell nevus syndrome)

94
Q

Age/loc of neuroblastoma

A

<5 YOA, loves the adrenals and also seen in cerebrum hemispheres

95
Q

Third and fourth eyes of the head, seen with retinoblastoma

A 
3rd = pineal gland
4th = suprasellar cistern
96
Q

Def ‘cats eye’ (Leukokoria)

A

Whitish mass behind the eye seen in 60% of retinoblastomas

97
Q

How common is lymphoma Mets

A

2nd MC mets (breast is MC and lung), found in the supratentorial region liking the frontal lobe and basal ganglia

98
Q

MC location of trigeminal nerve schwannoma

A

Trigeminal ganglion or Grasserian ganglion in Meckle’s cave

99
Q

MC cranial nerve affected by neurofibroma

A

Trigeminal CNV (V1 in particular)

100
Q

Loc of cranial epidermoid and dermoid tumors

A

Epidermoid - off midline, CP angle

Dermoid - Midline, parasellar, vermis, 4th ventricle

101
Q

Loc of an intracranial lipoma

A

Midline, usually around corpus callosum

102
Q

MC location of an arachnoid cyst

A

Middle cranial fossa

103
Q

MC loc of a colloid cyst

A

anterior to 3rd ventricle

104
Q

MC site of neuroglial cyst

A

Choroid plexus

105
Q

Def the Elster rule

A

Pituitary gland height being 6,8,10,12 mm

Kids, men/postmeno women, childbearing women, and postpartum

106
Q

MC malignant pituitary lesion

A

Mets

107
Q

MC type of pituitary adenoma (What is it secreting)

A

Prolactin-secreting

108
Q

def nelsons syndrome

A

Pituitary adenoma in patients with adrenectomy for Cushing

109
Q

Enhancement pattern of microadenoma on CT

A

Slow +C enhancement

110
Q

MC nonglial brain tumor in kids

A

Craniopharyngoma

111
Q

Congenital infections

A

TORCH (TOxoplasmosis, Rubella, CMV, HSV/HIV)

112
Q

MC congenital infectious agents

A

CMV

113
Q

What is affected with congenital CMV infection

A

CNS (70%), cardiac anomalies and hepatosplenomegaly

114
Q

Congenital CMV presentation

A

Neuronal migration disorder, periventricular calcification, delayed myelination, ventricular enlargement

115
Q

Triad of Toxoplasmosis infection

A

Hydrocephalus, Bi chorioretinitis and intracranial calcifications. NO NEURONAL MIGRATION DISORDER

116
Q

Severe changes from Varicella infection in fetus

A

necrotizing encephalomyelitis

117
Q

MC form of CNS infecion

A

Meningitis

118
Q

3 categories of meningitis

A

Acute pyogenic, lymphocytic and chronic

119
Q

MC agents causing meningitis in neonate, <7YOA, adolescent and adults

A

Neonate - group B strep
<7 - H influenza
adolescent - N. meningitidis
adult - Strep pneumonia

120
Q

% of ventriculitis in neonatal meningitis

A

90%

121
Q

MC loc of TB (Chronic) meningitis

A

Basal cisterns

122
Q

MC cause of brain abscess

A

Pyogenic bacteria (strep, staph or gram negative)

123
Q

4 stages of abscess formation

A
  1. Early cerebritis
  2. Late cerebritis
  3. Early capsule formation
  4. late capsule formation
124
Q

MC viral encephalitis

A

HSV

2 - in neonates and 1 in kids/adults

125
Q

MC opportunistic CNS infection in AIDS pts

A

Toxoplasmosis

126
Q

MC CNS pathogen in AIDS pts

A

HIV

127
Q

Cause of progressive multifocal leukoenchalopathy

A

Group B human papovavirus

128
Q

MC fungal infection in non-IC patients

A

Histoplasmosis

129
Q

MC fungal infection in IC patient

A

Aspergillosis, candida

130
Q

MC CNS parasitic infection and MC loc

A

Neurocysticercosis; Corticomedullary junction followed by ventricles

131
Q

General myelination pattern

A

caudad–> Cranial; Dorsal –>ventral; central–> peripheral

132
Q

T/F is gray-white matter signal reversed in neonates

A

True

133
Q

MC hereditary leukodystrophy

A

Metachromatic leukodystrophy

134
Q

Metachromatic leukodystrophy demylination site

A

Sym, deep periventricular white matter; primarily anterior lobes

135
Q

Globoid cell leukodystrophy is AKA

A

Krabbe dystrophy

136
Q

MC site affected by Krabbe dys

A

Centrum semiovale

137
Q

Lorenzo oil is AKA

A

Adrenoleukodystrophy

138
Q

Desc Alexander disease

A

Dysmyelination d/t Rosenthal fiber deposition, likes the frontal lobe

139
Q

Only Dysmylinating disorder to affect the subcortical U-fibers

A

Canavan Dz

140
Q

Def Phenylketonuria

A

Increased phenylalanine; autism, retardation, seizures, , greates changes to optic radiations, osseous metaphyseal cupping, osteoporosis, delayed maturation

141
Q

Batwing dilation of sylvian fissure is seen in

A

Glutaric aciduria type 1

142
Q

pattern of nonketoic hyperglycinuria

A

Decrease myelination of white matter

143
Q

Oculocerebral renal syndrome is AKA and Desc

A

Lowe syndrome; Cataracts, retardation, renal-tubular dz, rickets, supratentorial WM lesions

144
Q

What is Tay-sachs dz

A

Axonal death-demylination

145
Q

Mega neurites is ass’d with what disease (MPS)

A

MPS1-H - Hurlers

146
Q

Cortical atrophy is seen in which MPS

A

MPS 3(San Filippo) and MPS2 (Hunter)

147
Q

Brain changes in Wilsons disease

A

Calcificaions in Basal ganglia

148
Q

MC location of MS in kids

A

Infratentorial

149
Q

Def marchiatava-bignami

A

Alcoholics, demyelination of corpus callosum

150
Q

What dz contains Lewy bodies

A

Alzheimers and Parkinson with frontal lobe atrophy

151
Q

What is Picks dz

A

Frontotemporal lobe degeneration/atrophy with pick bodies

152
Q

Def neural placode

A

Neuronal tissue surface open to the air (NO DURA)

153
Q

MC cause of meningocele

A

Acquired –> Laminectomy

154
Q

MC cause of tethered cord

A

Spinal lipoma

155
Q

Anterior sacral meningocele is ass’d with what conditions

A

NF1 and Marfans

156
Q

% of spinal hemangioblastomas in pts with VHL

A

30%

157
Q

MC cause of pyogenic spondylitis

A

Staph aureus (2nd is enterobacter)

158
Q

1st and 2nd MC cause of granulomatous spondylitis

A

TB and brucella

159
Q

What type of cord matter do virus vs bacteria like

A

virus is gray

bacteria is white

160
Q

MC plaques in the cord are found where (in terms of axial slice)

A

Dorsolateral

161
Q

What is Devic dz

A

Spinal MS and optic nerve only

162
Q

MC spinal vascular anomaly

A

AVM/AVF type 1

163
Q

spinal AVM MC location

A

TL junction

164
Q

MC spinal location for osteochondroma

A

C2 usually SP or TP

165
Q

MC loc of epidural lipomatosis

A

T/s> L/s, never C/s

166
Q

Sinus seen on Caldwell projection

A

Frontal and ethmoid

167
Q

Sinus seen on Waters

A

Maxilla

168
Q

Sinus seen on Rheese projection

A

Post ethmoid with superimposition

169
Q

MC sinus with sinusitis

A

Maxillary

170
Q

Potts puffy tumor is

A

ST swelling over frontal sinus from OM

171
Q

What is Coalescent mastoiditis and Bezold

A

Mastoiditis that speads to bone and Bezold when it breaks through the cortex to create a subperiosteal abscess

172
Q

MC fx to skull base bone

A

Temporal bone

173
Q

MC primary tumor of temporal bone

A

Glomus

174
Q

MC salivary gland tumor

A

Pleomorphic adenoma

175
Q

Def Warton tumor

A

benign parotid gland tumor

176
Q

What is ass’d with spinal ependymoma

A

NF2

177
Q

Meningiomas in kids is ass’d with what

A

NF2

178
Q

Loc in the spinal cord (cross-section) for a hemangioblastoma

A

Posterior cord

179
Q

Age and loc of a PNET brain

A

Children; sellar/suprasellar

180
Q

Compression of the tectal plate can cause what syndrome

A

Perinaud syndrome - inability to gaze upward

181
Q

DDx for a butterfly lesion of the corpus callosum

A

GBM, primary CNS lymphoma and mets

182
Q

Loc of Rathke cleft cyst

A

Intra and suprasellar mixed - 70%

183
Q

% of a solitary enhancing brain tumor is mets

A

50%

184
Q

Imaging differences in parkinson plus syndromes (Multisystem atrophy vs Progressive supranuclear palsy)

A

MSA - Spares the midbrain

PSP - Spares the Pons (hummingbird sign)

185
Q

MC cause of basal ganglia calcification

A

Idiopathic/physiologic aging

186
Q

Familial idiopathic striopallidodentate calcification is known as

A

Fahr dz

187
Q

Rad of basilar meningitis

A

Intense enhancement with pituitary and parasellar involvement, Ca seen in late dz

188
Q

MC loc and cause of empyema

A

Subdural space and sinusitis

189
Q

DDx for lyme dz is

A

MS and ADEM

190
Q

Ring enhancing lesions brain

A

DR MAGICAL
Demylinating (incomplete ring on the central portion), Radiation, Mets, Abscess, GBM, Infarct, Contusion, AIDS and Lymphoma

191
Q

At what measurement is tonsilar herniation called

A

> 5mm

192
Q

Chiari 1 vs 2 is seen in what age

A

Chiari 1 = Adult, Chiari 2 = newborn

193
Q

MC loc for a cephalocele

A

Occipital

194
Q

What conditions typically affect corpus callosum development

A

Dandy-walker, lipoma, Chiari 2, encephalocele, migration anomalies

195
Q

What chromosomal syndrome is ass’d with holoproscencephaly

A

Pateau (13)

196
Q

Mild form holoproscencephaly

A

Septo-optic dysplasia

197
Q

2 congenital syndrome with spinal stenosi

A

Achondroplasia and Morquio

198
Q

Cap sign is suggestive of what spinal tumor

A

Ependymoma, can also be seen in hemangioblastoma and paragangliomas

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