Nuerology Problems And Scanning

Question 1

Spinal uss is good <3/12 of age for investigation of spinal problems

Answer 1

True

Most low sacral dimples are benign

Question 2

Scoliosis

Answer 2

Lateral curvature of spine one or more >10degrees
1% of pop has scoliosis
3/1000 need treatment
Types are primary80% ( adolescent 90% juvenile 10% infantile 0.5%)
And secondary

Question 3

Adolescent scoliosis

Answer 3

11-17years

F>M

Question 4

2ary scoliosis

Answer 4

Congenital vertebral anomalies 
Neuromuscular eg muscular dystrophy CP
Focal pathology tumors infection/ trauma 
Skeletal problems short statue 
Congenital NF1/ Marfans

Question 5

Ix in Scoliosis

Answer 5

X-ray for Cobs angle it defines the curvature and says if there is a vertebral abrnomality
MRI pre plan you for surgery
Useful if strange examination pain, progressive

Question 6

Measuring cobbs angle

Answer 6

Universal standard for measuring and quantify the magnitude of the spinal curvature
Upper end plate and bottom end plate of the curve
Focal scoliosis is often short VS idiopathic adole scoliosis which is long S curve

Question 7

Increasing HC in infant

Answer 7

USS is helpful till about 6/12 of age gives some info

Ant Fontenell peak size is 1/12 of age 2 cm

Question 8

When do the fontelles close

Answer 8

Ant 9-18 months

Post 3-6 months

Question 9

USS of head in infant

Answer 9

Hydrocephalus 
Haemorrhages 
Tumor /mass effect
Some congenital abnormality 
Flow into thesagittal sinus

Question 10

Abnormal head shape dd craniosynostosis ( 1/2000) / positional polagiocephaly ( 1/300)

Answer 10

Cranisosynostoiss early fusion of the sutures
X-RAY is the preferred method
CT may be needed if the abnormality persists

Question 11

Pediatric trauma

Answer 11

Trauma leading cause of death in children>1 year

TBI leading cause of death and disability in children

Question 12

TBI

Answer 12

X-ray limitation can have significant brain trauma and NO #
CT = modality of choice
Extramural and subdural Haematoma

Question 13

CNS tumors

Answer 13

2nd most common cancer in children ( after Leukemia)
0-3 Suprtatenorial tumors
4-10 infra tentorial tumors

Question 14

Symptoms of brain tumor

Ix of symptoms

Answer 14

Increasing HC 
Vomiting , nausea/ lethargy 
Irritable /behavour change /headache
Focal neurological signs  Ataxial/hemiplgia 
Seizure 
Endocrine abnormality 

Acute presentation CT scan often done
MRI method of choice
Surgical planning and treatment

Question 15

Retinoblastoma

Answer 15

USS of eye may assist

MRI

Question 16

Periorbital/orbital cellulitis

Answer 16

CTscan of the head with contrast

Question 17

Sinusitis ? Abscess

Answer 17

Ct scan of head is the preferred method

Dd venous sinus thrombosis