WlwG Neuro (Infn/Inflm/Degen/Paeds) Flashcards
1
Q
Grey matter: Frontal atrophy
A
FrontoTemporal dementia/Pick’s disease, loss of interest
2
Q
Grey matter: Temporoparietal atrophy, disproportional hippocampus
A
Alzheimers, forgetfulness
3
Q
Grey matter: General/Brainstem atrophy sparing hippocampus
A
Lewy body dementia, visual hallucination and parkinsonism
4
Q
Grey matter: Scattered general, dementia
A
Vascular dementia, associated with HTN/cadasil/smoking
5
Q
White matter: T2/flair hyper in child
A
ADEM
6
Q
White matter: T2/flair hyper in women disseminated in time/space
A
MS
7
Q
White matter: Adult with diffuse strokes, migraine, dementia, excl occipital
A
Cadasil
8
Q
White matter: Old with white matter dementia
A
SCARED, SubCortical ARteriosclerotic Encephalopathy Disease = Subcortical, Centrum semiovale, Atrophy, Really Elderly, Dementia
9
Q
White matter: Bilat asymmetrical periventricular
A
MS
10
Q
White matter: Bilat asymmetrical confluent after infection
A
ADEM
11
Q
White matter: Bilat symmetrical T2-hyper sparing subcortical U-fibres
A
HIV encephalopathy
12
Q
White matter: Bilat symmetrical basal ganglia in immunocompromised
A
Cryptococcus
13
Q
White matter: Unilateral medial temporal lobe/insula
A
Herpes simplex encephalitis
14
Q
Basal Ganglia: T1-hyper in midbrain
A
Parkinsons, from melanin
(“Middle-aged Melanie has Parkinsons”)
15
Q
Basal Ganglia: T1-hyper in putamen/thalamus
A
Wilsons, from copper
16
Q
Basal Ganglia: T1-hyper in basal ganglia/thalamus
A
Fahrs, from calcification
17
Q
Basal Ganglia: T1-hyper/T2-hypo in globus pallidus with rigidity/bradykinesia
A
Hallervorden Spatz, from iron. (“Behave like Hell then spit at GP”)
18
Q
Basal Ganglia: T2-hyper in basal ganglia/brainstem in infant
A
Leighs
19
Q
White matter: Bilateral peri-ventricular in infant who cant walk/swallow/see
A
Metachromatic Leuko-Dystrophy
20
Q
Basal Ganglia: T2-hyper with orogenital ulcers, eye problems
A
Behcets
21
Q
Basal Ganglia: T2/flair-hyper in internal capsule with muscular problems
A
Amyotrophic lateral sclerosis/ALS
22
Q
Smalls: Pons/cerebellum, normal midbrain
A
Multi-system atrophy/MSA
23
Q
Smalls: Midbrain, normal pons
A
Progressive Supranuclear Palsy/PSP (“hummingbird midbrain”)
24
Q
Smalls: Caudate
A
Huntingtons
25
Toxic encephalopathies: Occipital/cerebellum T2-hyper patches, from chemo
PRES ("posterior")
26
Toxic encephalopathies: Periventricular bilateral T2/flair hyper from chemo/RT/heroin
LeukoEncephalopathy
27
Toxic encephalopathies: Pons T2-hyper from alcohol/cirrhosis/TIPS
Osmotic demyelination syndrome/Central pontine myelinolysis
28
Toxic encephalopathies: Thalamus T2/flair-hyper with small cerebellum/brainstem from alcohol
Acute = Wernickes
Chronic = Korsakoffs
(Low Thiamine/Vit B1)
29
Toxic encephalopathies: Corpus collosum T2-hyper with seizures/AMS from alcohol/cirrhosis/TIPS
Marchiafava-Bignami syndrome
30
Toxic encephalopathies: Insula T2/flair-hyper from alcohol/cirrhosis/TIPS
Hepatic encephalopathy
31
Toxic encephalopathies: Globus pallidus T2-hyper with headache, cerebral oedema, haemorrhages
Carbon monoxide (compare to thalamus/pons in alcoholic)
32
Toxic encephalopathies: Putamen T2-hyper with haemorrhages
Methanol
33
Toxic encephalopathies: Bilateral basal ganglia DWI/T2/Flair-hyper with dementia/psychosis
CJD
34
Meningitis causes in neonate vs child vs adult
Neonates (group B strep, E coli), Children (Haemophilus, E. coli), Adults (Strep pneumoniae, Neisseria meningitides)
35
TB meningitis signs
Basilar meningeal involvement with HYDROCEPHALUS +/- abscesses
36
Empyema signs
Pus in subdural or epidural space due to sinusitis, otitis or trauma/surgery. T1-HYPER, DR with low-attenuation fluid collection and adjacent brain enhancement.
37
Cerebral abscess appearance and causes
IVDU, staph, strep, pneumococcus. If immuno-compromised (toxoplasmosis, cryptocococcus, candidiasis, aspergillosis, TB). RIM-ENHANCEMENT, DR, surrounding oedema.
38
NeuroCystiCercosis vs Lyme disease signs?
NeuroCystiCercosis: Taenia/tapeworm parasite in South America with seizures and ring-enhancing lesion/cysts
Lyme disease: Borrelia infection mimicking MS lesions (“Lyke MS”).
39
Herpes simplex: HSV1 vs HSV2 signs
HSV1 (Oral herpes with AMS), HSV2 (Genital herpes with diffuse encephalitis) (“Oral before sex”)
40
HIV neuro: HIV encephalitis vs Progressive multifocal leukoencephalopathy, 2 main differences?
HIV Encephalitis: Diffuse SYMMETRIC deep white matter T2/Flair-hyper, brain ATROPHY.
Progressive Multi-focal Leuko-Encephalopathy (PML): Scattered hypodensities with ASYMMETRIC T2/Flair-HYPER, no brain atrophy.
41
TORCHS organs involved?
“Organs affected from top to bottom:"
To/Toxoplasmosis = ventricles (hydrocephalus) & eyes
R/Rubella = eyes/ears/heart
C/CMV = liver/spleen
H/HSV2 = skin
S/Syphilis = premature and everywhere, lymph nodes
42
TORCHS brain components involved?
Brain affected:
To = hydrocephalus/abscess/calcs
R = deaf/cataract
C = small brain
H = oedema/haemorrhage/infarct
S = premature/everything
43
Paeds disorders: Small skull, normal brain
Chiari malformation, thus herniation
Chiari 1 = downward displacement of cerebellar tonsils
Chiari 2 = upward displacement of brainstem
44
Paeds disorders: Small skull and brain
Microcephaly
45
Paeds disorders: Frontal/ethmoidal external herniation of brain
Encephalocoele/MeningoEncephalocoele
46
Paeds disorders: Occipital external herniation of brain
Dandy-walker/Chiari malformation
47
Paeds disorders: Dilated 4th ventricle and cieterna magna with large head
Dandy-walker
48
Paeds disorders: Dilated 3rd ventricle
Agenesis of corpus callosum
49
Paeds disorders: Dilated lateral ventricle
HemiMegalEncephaly
50
Paeds disorders: Dilated fronto-temporal cleft
SchizEncephaly
51
Paeds disorders: Fused midline
HoloProsEncephaly
52
Paeds disorders: Premature closure of cranial sutures with deformed skull shape
CranioSynostosis
53
Paeds disorders: CranioSynostosis with distal problems (fused fingers/syndactyly)
Aperts (“A Bird, so fused fingers”)
54
Paeds disorders: CranioSynostosis with proximal problems (short humerus/femur), choanal atresia (nose not connected to oropharynx)
Crouzons (“Croissant-look, so small head, short arms/legs, obstructed nose”)
55
Paeds disorders: Widened cranial sutures
Suture diastasis (from trauma/raised ICP/hydrocephalus, low PO4/VitD/parathyroid
56
Paeds disorders: Additional bone squiggles between cranial lambdoid suture
Wormian bone (<10 extra bones = normal variant, >10 extra bones = osteogenesis imperfecta, >10 extra bones with absent clavicle = cleidocranial dysostosis)
57
Paeds disorders: CranioSynostosis with closure of metopic (anterior) suture
Trigonocephaly ("Triangular forward pointing head")
58
Paeds disorders: CranioSynostosis with closure of sagittal suture
Scaphocephaly ("Sagittal, Scaphocephaly")
COMMONEST craniosynostosis overall
59
Paeds disorders: CranioSynostosis with closure of coronal suture
Unilateral = plagiocephaly
Bilateral = brachycephaly
60
Paeds disorders: Blurring of grey-white matter differentiation with seizures
Focal cortical dysplasia
61
Paeds disorders: Hippocampus/mammillary body atrophy/gliosis, T2-hyper
Mesial temporal (medial temporal ie hippocampus) sclerosis (ie small/scarred)
62
Paeds disorders: Cerebellar atrophy, upper motor neuron weakness
Friedreich ataxia
63
Paeds disorders: NF1 signs
NF1: Cafe-au-lait spots, iris hamartomas, freckling, neurofibroma. Tibia pseudoarthrosis, scoliosis, thoracic meningocoele
NF2: Bilateral acoustic neuromas, glioma/meningioma/neurofibroma
64
Paeds disorders: NF2 signs
NF1: Cafe-au-lait spots, iris hamartomas, freckling, neurofibroma. Tibia pseudoarthrosis, scoliosis, thoracic meningocoele
NF2: Bilateral acoustic neuromas, glioma/meningioma/neurofibroma
65
Paeds disorders: Localised subcutaneous bag-of-worms mass in NF1
Plexiform neurofibroma
66
Von hippel lindau signs
(“HiPPEL = Haemangioma, Pheo, Pancreatic cysts, Eye haemangioblastoma, Liver cysts”)
67
Tuberous sclerosis signs
Bilateral renal AMLs with pulmonary LAM, cardiac rhabdomyosarcoma, diffuse hamartomas (“TUBAH = Tubers, AML, Hamartomas”).
68
Sturge-Weber signs
PORT-WINE SKIN nevus in Trigeminal distribution, seizures, mental retardation.
69
Dermoid vs epidermoid?
Dermoid cyst: SKIN/HAIR/CALCIFICATIONS/sweat glands cyst in midline region in child/youth, rim-enhancing with heterogeneous appearance.
Epidermoid cyst: ONLY SKIN CONTENTS cyst in parietal region in young adult
70
Fetal hydrops, fetal cardiomegaly, dilated median prosencephalic vein
Vein of Galen AV malformation
71
Neonatal HIE: 3 signs
Global cerebral oedema, peri-ventricular leuko-encephalopathy (PVL), peri-ventricular haemorrhage
72
Peri-Ventricular Leukomalacia (PVL) signs
PREMATURE, SMALL neonate, peri-ventricular white matter appears BRIGHTER THAN CHOROID, due to hypoxic injury with cavitations, cysts and mental retardation/cerebral palsy.
73
PVL vs PML vs Leukoencephalopathy vs Metachromatic leukodystrophy vs adrenoleukodystrophy/ALD
Periventricular leukomalacia/PML = PREMATURE, SMALL neonate, peri-ventricular white matter appears BRIGHTER THAN CHOROID in neonatal HIE
Progressive Multi-focal Leuko-Encephalopathy/PML in HIV = Asymmetric T2/flair-hyper without brain atrophy (compared to HIV encephalitis which is symmetrical and brain atrophy)
Leuko-Encephalopathy in chemo/RT/heroin = T2/flair-hyper in bilateral periventricular in adult
Metachromatic Leuko-dystrophy in infant = T2/flair-hyper in bilateral periventricular infant who cant walk/see/swallow
AdrenoLeukoDystrophy/ALD in young males = T2/flair-hyper in bilateral periventricular and corpus callosum in young males with motor/vision/hearing problems
("LeukoDystrophy distrophic so neuro problems
Leuko-Encephalopathy, so short term, but progressive in HIV infn while normal one in any insult like chemo/RT/heroin
Leuko-Malacia, thus looks whiter in premature")
74
Signs of AdrenoLeukoDystrophy (ALD)
X-linked genetic condition, thus young males with demyelination of peri-ventricular white matter, especially corpus callosum. Progressive loss of motor, cognitive, vision and hearing functions, raised very long chain fatty acids (VLCFA).
75
Paeds disorders: Multiple telangiectasias with brain infarct/haemorrhage/cerebellar ataxia
Ataxia telangiectasia
76
Paeds bleeds: Under cranial periosteum, does not cross sutures
CephaloHaematoma
77
Paeds bleeds: Between aponeurosis and periosteum, cross sutures
Sub-galeal haematoma
78
Paeds bleeds: Under skin, cross sutures
Caput succedaneum
79
Toxic encephalopathies: HIV encephalopathy vs PML
Bilateral diffuse SYMMETRICAL, with brain atrophy = HIV encephalopathy
Bilateral diffuse ASYMMETRICAL, no brain atrophy = Progressive Multi-focal Leuko-Encephalopathy (PML)
80
Toxic encephalopathies: Cryptococcus vs Herpes simplex vs HIV
Bilateral diffuse SYMMETRICAL, with brain atrophy = HIV encephalopathy
BL symmetrical basal ganglia = Cryptococcus
Unilateral medial temporal lobe/insular = Herpes simplex encephalitis
81
Neuro conditions: Eye of tiger sign
Hallervorden spatz (iron in globus pallidus)
82
Paed Neuro: Types of Porencephaly/Schizencephaly
Cleft/TRACT connecting lateral ventricle to subarachnoid space.
Open means CSF tract visible
Closed means tract not visible cause the opposing surfaces are close together.
83
Paeds Neuro: Types of Holoprosencephaly
Lobar (mild): Absent septum pellucidum only
Semilobar (moderate): Above + partial falx, small 3rd ventricle
Alobar (severe): Absent septum pellucidum, absent falx, absent 3rd ventricle
84
Neuro Basal Ganglia conditions by location: Mnemonic
From anterior to posterior: CLIT = Caudate, Lentiform, Insula, Thalamus, Midbrain, Pons, Medulla
("March my hall carbs & all her liver, we were far 'from' parking oddly, forget crying leh bae")
(Depository conditions are T1-hyper, rest are T2-hyper)
Caudate: T2 Marchiafava
Lent-Putamen: T2 Methanol
Lent-Globus Pallidus: T1 Haller, T2 CO
Insula: T2 ALS, Hepatic encephalopathy/liver, Unilateral Herpes
Thalamus: T1 Wilsons/Fahrs, T2 Wernicke-Korsakoff
Midbrain: T1 Parkinson
Pons: T2 Osmotic-demyelination/ODS
Whole BG: Infant T2 Leighs, Oro-genital T2 Behcets, Symmetrical T2 Cryptococcus, Dementia T2 CJD
