videos

Question 1

3 most common cranial nerve schwannomas

Answer 1

1. vestibular
2. trigeminal
3. facial

Question 2

clinical vestibular schwannoma

Answer 2

slow course- cochlear nerve dysfunction- unilateral tinnitus and progressive sensorineural hearing loss with early loss of speech discrimination.

sense of imbalance

Question 3

In patients presenting with bilateral vestibular schwannomas, ____ should be suspected.

Answer 3

neurofibromatosis type 2

Question 4

preferred imaging modality to detect vestibular

schwannomas.

Answer 4

MRI with gadolinium enhancement

Question 5

treatment of vestibular schwannoma

Answer 5

observation

surgery- elective stereotactic radiosurgery

radiation therapy.

Question 6

other conditions causing the cerebellopontine angle

syndrome include

Answer 6

meningiomas, lipomas, cholesteatomas, arachnoid cysts, epidermoids, hemangiomas, vascular loops,
vertebral dolichoectasia, arteriovenous malformations, and metastatic tumors.

Question 7

dysfunction of neighboring CNs based off location of schwannoma

Answer 7

anterior - 5 and 6

posteroinferior: 9, 10, 11

7 usually involved

Question 8

autonomic symptoms of cluster HA

Answer 8

due to sympathetic paresis and parasympathetic system overactivity:

-conjunctival injection, lacrimation, rhinorrhea, and eyelid ptosis and miosis

Question 9

cluster HA types

Answer 9

(i) episodic,
(ii) chronic (primary vs secondary)
(iii) chronic paroxysmal hemicrania,
(iv) cluster headachelike syndrome.

Question 10

cluster HA timing characterstics

Answer 10

each episode: 15 to 30 minutes up to 180 minutes

Episode frequency: every other day- 8x/day

Periods last: 2-3 months

Period frequency: every 1 to 2 years.

Question 11

chronic cluster HA is a period that lasts longer than

Answer 11

6 months without remission or with remissions lasting less than 2 weeks.

Question 12

chronic paroxysmal hemicranias characteristics

Answer 12

shorter episodes (5-45), but more frequent (7-22/day)

Question 13

Chronic paroxysmal hemicrania is more common among ____ and is responsive to ____

Answer 13

women

indomethacin

Question 14

Symptomatic forms of cluster headache - meaning, lesions that can cause cluster like HAs

Answer 14

lesions near the cavernous sinus, including

– tumors (e.g., parasellar meningiomas, pituitary adenomas,nasopharyngeal carcinomas),

–vascular malformations: carotid and vertebral artery aneurysms, and giant cell arteritis
among others.

Question 15

The most effective symptomatic treatment of cluster

headache is

Answer 15

inhalation of high-flow concentrated oxygen, 6 to 8 L per min by face mask, for no longer than 20 minutes.

Question 16

Other abortive strategies include the

Answer 16

intranasal administration of 4% lidocaine, subcutaneous sumatriptan, sublingual or inhaled ergotamine, and injectable dihydroergotamine (DHE 45 injection) preparations.

Question 17

The prophylactic treatment of episodic cluster headaches includes

Answer 17

**verapamil,

ergotamine, lithium carbonate, methysergide, prednisone, divalproex, and topiramate.

avoid etoh!

Question 18

methysergide limitations

Answer 18

don’t use for mre than 6 mo

se: retroperitoneal, endocardial, and pulmonary fibrosis.

Question 19

diagnosis of pseudotumor cerebri

Answer 19

(i) sxs and signs of raised ICP (headaches, transient
visual obscurations, and horizontal diplopia due to unilateral or bilateral CN VI palsy),

(ii) normal neuroimaging studies (MRI and MRV)
(iii) increased opening CSF pressure (> 250 mm H2O) with normal composition (may show a low CSF protein).

Question 20

substances that can cause pseudotumor cerebri

Answer 20

tetracyclines, nalidixic acid, amiodarone, corticosteroids, danazol, lithium, hypervitaminosis A,
cyclospo- rine, indomethacin, growth hormone, and so on.

Question 21

conditions that can cause pseudotumor cerebri

Answer 21

corticosteroid withdrawal, pregnancy, menarche, systemic lupus erythematosus (SLE) and other systemic diseases, hypoparathyroidism, thyroid replacement, high-flow arteriovenous malformations, radical neck dissection and other disorders of cerebral venous drainage.

Question 22

Differential diagnosis of patients presenting with bilateral swollen optic discs

Answer 22

papilledema due an:

 intracranial mass lesion, 
papillitis,
 anterior ischemic optic neuropathy (AION), pseudopapilledema,
optic nerve head drusen, 
bilateral optic nerve tumors, 
malignant hypertension.

Question 23

Uncontrolled papilledema may result in

Answer 23

progressive peripheral visual field constriction or nerve fiber bundle defects.

Question 24

treating pseudotumor cerebri

Answer 24

weight loss

acetazolamide, furosemide

if optic nerve dysfunction- surgery (of optic nerve sheath fenestration or lumboperitoneal
shunt)