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Core Exam > Neuro > Flashcards

Neuro Flashcards

1
Q

Appearance of cytotoxic edema?

Causes?

A
  • Loss of greywhite differentiation
  • Infarction
  • Hypoxic injury
  • HSV encephalitis
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2
Q

Appearence of vasogenic edema?

Cause?

A
  • White matter only becomes hypodense
  • Malignancy (primary or secondary)
  • Abscess
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3
Q

What is the cellular etiology for cytotoxic edema?

A
  • Failure of N/K pump
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4
Q

What is the cellular etiology for vasogenic edema?

A

BBB breakdown

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5
Q

How is area at risk defined on CT perfusion?

A

Time to maximal perfusion (Tmax) > 6.0s

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6
Q

How is the area of infarct core defined on CT perfusion?

A

Volume of brain tissue with cerebral blood volume <30% of the contralateral side.

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7
Q

How is penumbra defined on CT perfusion?

A

Brain volume with Tmax > 6.0s - Brain volume with cerebral blood flow <30% = penumbra volume

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8
Q

Whats the next step if vasogenic edema is spotted on a noncontrast head CT?

A

Give IV contrast to check for tumor or abcesss

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9
Q

Whats the classic appearance of abscess on contrast enchanced T1 and DWI?

A

Rim enhancement with central non-enhancing pus which is bright on DWI.

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10
Q

What is the classic territory of involvement of HSV encephalitis?

A

Temporal horn and insula sparing the basal ganglia

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11
Q

A perfectly round brain parenchymal hemorrhage should make you suspicious of what?

A

a metastasis that has bled into itself

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12
Q

How do you differentiate a primary vs secondary intraaxial bleed?

A
  • Primary bleed will have very little vasogenic edema. A secondary bleed will have large amount of vasogenic edema secondary to the primary lesion.
  • Irregular shape - primary
  • Round - secondary
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13
Q

What are the most common locations for hypertensive headahce?

A
  • Basal ganglia (putamen)
  • Thalamus
  • Pons
  • Cerebellum (dentate nucleus)
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14
Q

What is a lobar intracranial hemorrhage ?

A

Superficial bleed involving within the lobes of the brain (i.e. not the basal ganglia) which is strongly associated with amyloid angiopathy in the elderly

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15
Q

What the etiology of lobar hemorrhage in a young person?

A

AVM

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16
Q

Can extraaxial hemorrhage cause cerebal edema?

A

No. Only intraaxial hemorrhage can cause cerebral edema.

17
Q

What parts of the brain does diffuse axonal injury affect?

A
  • Grey white matter junction
  • Corpus callosum
  • Brain stem (most severe cases)
18
Q

Whats the most important prognostic factors for diffuse axonal injury?

A
  • Age >35

- Involvement of mid-brain

19
Q

What is a common sequela of venous infarcts?

A

50% of venous infarcts bleed. In contrast arterial bleeds don’t commonly bleed

20
Q

16 year old boy with epistaxis, nasal mass and widening of sphenopalatine foramen?

A

Juvenile angiofibroma

21
Q

Key anatomical landmark in orbital cellulitis

A

Orbital septum

  • Preseptal (less severe)
  • Postseptal (severe)
22
Q

How to differentiate acute from choronic sinusitis

A

Acute: Air fluid level
Chronic: mucosal thickening

23
Q

What is Potts Puffy Tumor?

A

Subperiostial abcess and osteomeylitis from direct extension of obstructed sinusitis

24
Q

Normal variants of the dens

A

os odontinaum- childhood fxr that heals
os tirminale- small separate center of ossification

Both are fully cortiacted (unlike a fxr)

25
Q

What is a hangman’s fxr?

A

Fxr of C2 pedicles

26
Q

What the two types of teardrop fxrs? Which is more servere? Why?

A
  • Flexion (more severe; associated with ligamentous injury)

- Extension

27
Q

What is disc bulge?

A

Extension of disc beyond vertebral body involving >25% of the circumference

28
Q

What is disc herniation

A

Extension of disc beyond vertebral body involving <25% of the circumference.

29
Q

What is disc protrusion? extrusion?

A

Protrusion (subtype of herniation)

  • Neck is wider than herniated material
  • Annular fibers are in tact
  • No extension beyond disc level

Extrusion (subtype of herniation)

  • Neck is narrower than dome
  • complete tear of annular fibers
  • May extend cranialy or caudally
30
Q

What are the classifications of disc herniation?

A

Protusion vs Extrusion

Contained vs Not contained

31
Q

What defines a contained disc herniation

A

Disc material has not herniated beyond posterior longitudinal ligament.

Core Exam (6 decks)

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