Peds neuro

Question 1

Corpus callosum:

1. The CC begins development at which age?
2. The major components of the CC are present by which age?
3. CNS myelination is typically complete by what age?
4. Which abnormalities are shown below?
5. Based on these findings, what is the DDx?

Answer 1

1. 8th week gestation.
2. 17th week.
3. 2 yrs.
4. Absence of the CC and septum pellucindum, colpocelphaly (dilated ventricles) and parallel lateral vents.
5. DDx:
   
   1. chromosomal abnormality,
   2. Chiari malformations
   3. cerebral palsy
   4. prenatal teratogen exposure
   5. metabolic syndrome

Question 2

The most common neck mass in infancy?

Answer 2

Fibromatosis colli.

Question 3

The most common masticator space mass in a kid?

Answer 3

rhabdomyosarcoma

Question 4

The most common extra-orbital malignancy in kids?

Answer 4

rhabdomyosarcoma

Question 5

The most common benign orbital mass in a kid?

Answer 5

dermoid

Question 6

In schizencephaly, the abnormal cerebral cleft is lined by which substance?

Answer 6

Dysplastic gray matter.

Question 7

The most common complication of sinusitis?

Answer 7

orbital cellulitis

Question 8

3 findings required to diagnose classic Dandy-Walker malformation?

Answer 8

1. Enlarged posterior fossa w/upward displacement of the tentorium.
2. Severe vermian (vermis) hypoplasia or agenesis.
3. Cystic dilation of the 4th vent.

• If you do not see all 3 findings then it is a Dandy Walker variant.

Question 9

The most common primary brain tumour in kids?

Answer 9

juvenile pilocytic astrocytoma

• low grade (WHO grade 1)
• cerebellum is the most common site of origin (60%)
• optic chiasm is the next-most
• classic look: cystic mass w/enhancing mural nodule

Question 10

1. What does CHARGE stand for?
2. With what head/neck pathology is this often associated?

Answer 10

1. CHARGE:
   
   • coloboma
   • heart defect
   • atresia-choanal
   • retarded growth
   • GU abnormalities
   • ear abnormalities
2. choanal atresia

Question 11

1. Name the TORCH infections.
2. Which one is most common?
3. Typical intracranial findings with CMV, but any TORCH infections?

Answer 11

1. Toxoplasmosis, HIV, rubella, CMV, HSV.
2. CMV; affects 1% of all newborns.
3. Microcephaly, periventricular calcs, mineralized basal ganglia.

Question 12

Dx, 15yo female w/headaches & vomiting.

Answer 12

Pineoblastoma: pineal region mass that is mixed cystic & solid & iso to gray matter.