Neurology Flashcards
Weeks of primary and secondary Neurulation and associated defects
Primary: weeks 3-4 (anencephaly, encephalocele, myelomeningocele, Arnold-Chiari
Secondary: weeks 4-7 (tethered cord)
Palmar Reflex: appearance, established, disappearance
26 weeks
32 weeks
2-4 months (persistence = athetoid CP)
Think of those 26-28 weekers grabbing their ETT and pulling out.
Plantar Reflex: appearance, established, disappearance
26 weeks
32 weeks
9-12 months
Palmar and plantar start and established at same time. Plantar delayed disappearance.
Sucking Reflex: appearance, established, disappearance
28 weeks
32-34 weeks (suck swallow breathe and start taking bottles)
12 months
Crossed extensor Reflex: appearance, established, disappearance
30 weeks
34 weeks
2 months
Rooting Reflex: appearance, established, disappearance
30 weeks
34 weeks
4 months
Moro Reflex: appearance, established, disappearance
30-34 weeks
38 weeks
2-4 months
Tonic neck Reflex: appearance, established, disappearance
35 weeks
2 months
6 months
Placing and stepping Reflex: appearance, established, disappearance
35 weeks
Term
2-3 months
Which is more common: diffuse or cystic PVL
Diffuse is more common and better seen in MRI
(Cystic/focal necrosis is less common and seen easier on ultrasound. Most evident at weeks 2-4)
Risk factors for IVH
Low GA
-Male sex
-Surfactant deficiency
-Hypercapnea (⬆️ in brain ⬆️ flow. ⬆️CO2 in lungs ⬇️ flow… brain and lung blood flow is opposite for O2 and CO2 effects)
-Pneumothorax
-Fluctuating arterial BP
-Early hypotension
Does IVH cause PVL?
NO
PVL is from ischemia in watershed areas/poor vascular supply of periventricular white matter. Hypoxia and ischemia alters oligodendrocytes. Also free radical injury.
Difference in Arnold-Chiari and Dandy Walker
AC: primary neurulation prob. Cerebellum below foramen magnum. 4 types.
DW: vermis hypoplasia. Enlarged 4th vent.
Both may be treated with decompression/ shunt
