LearnNeurosurgery.com
  • Index
    • 3 Column Model
    • ACh: Acetylcholine
    • Acute MS
    • Ia (A-alpha) Muscle Spindles
    • Ib (A-alpha) Golgi Tendon
    • II (A-beta) - touch, vibration, pressure
    • Acid-Base
    • Actinomyces
    • ABC: Aneurysmal Bone Cyst
    • Acute Transverse Myelitis
    • Aldosterone
    • AA: Anaplastic Astrocytoma
    • Achondroplasia / Dysplastic Pedicle Syndrome
    • ACTH
    • Acute Phase Reactants
    • AD: Alzheimer's Disease
    • ADEM
    • ADH / Vasopressin
    • AEDs: Anti-Epileptic Drugs
    • AIDP / Guillain-Barre
    • Angiolipoma
    • Alcohol
    • Alexia without Agraphia
    • Alpha-2
    • AIP: Acute Intermittent Porphyria
    • ALS: Amyotrophic Lateral Sclerosis
    • Altitudinal Retinal Defect
    • Amaurosis Fugax
    • Amyloid Angiopathy
    • Anemia
    • Anencephaly
    • Anesthetics
    • Angiogram Anatomy
    • ANS: Autonomic Nervous System
    • ANS Dysautonomia
    • Arachnoiditis
    • ARDS: Acute Respiratory Distress Syndrome
    • ARF: Acute Renal Failure
    • Carotid Artery Dissection
    • Agenesis of Corpus Callosum
    • Aneurysms - By Type
    • Ankylosing spondylitis
    • Aqueductal Stenosis
    • Arachnoid Cyst
    • Ataxia-Telangectasia
    • ATRT: Atypical Teratoid Rhabdoid Tumor
    • AVM: Arteriovenous Malformation
    • Bacteria
    • Balo's Concentric Sclerosis
    • BA: Basilar Artery
    • Behcet
    • Bell's Palsy
    • Beriberi
    • Black Widow Spider
    • Blue Rubber Bleb
    • Bone Hemangioma
    • Botulism
    • Brain Herniation
    • Brainstem Glioma - Medulla
    • Buerger's Thromboangitis Obliterans
    • Burst Fracture
    • Caput Medusa
    • Cardiac Arrhythmias
    • Cardiac Tamponade
    • Carotidynia
    • C1 - Atlas
    • C1 - C2
    • C2 - Axis / Odontoid / Dens
    • C5-6: Erb's Palsy
    • C3-C7 - Subaxial Cervical Spine
    • CN XI: Spinal Accessory Nerve
    • CADASIL
    • Capillary Telangiectasia
    • Carbon Monoxide Poisoning
    • Cardiac & Renal Drugs
    • Cardiac Risk Index
    • Carotid Stenosis
    • CCF: Carotid Cavernous Fistula
    • Cavernous Malformation
    • C. Diff: Clostridium difficile
    • Cerebral Autoregulation
    • Central Neuroblastoma
    • Central Neurocytoma
    • Cephalohematoma
    • Cerebrovascular Disease
    • Cerebral Abscess
    • Cerebral Arteries - Embryology
    • Cerebral Cortex - Frontal Lobe
    • Cerebral Edema
    • Cerebral Palsy / Spasticity
    • Cervical Spine Trauma
    • Cervical Degenerative Disease
    • Cervical Plexus
    • Chance Fracture
    • Chemical Vasculitis
    • Chemotherapy Drugs
    • Chiari Malformation
    • Cholesterol Granuloma
    • Cholinergic Crisis
    • Chordoma / Chondrosarcoma / Chondroid Chordoma
    • Choroid Plexus Papilloma / Carcinoma
    • Chromosomal Abnormalities
    • CIDP: Chronic Inflammatory Demyelinating Polyneuropathy
    • Classic Avellis Syndrome
    • Cleidocranial Dysostosis
    • CNS Lymphoma
    • CN II: Optic Nerve
    • CN III: Oculomotor Nerve
    • CN IV: Trochlear Nerve
    • CN VI: Abducens Nerve
    • CN VII Pathology
    • CN IX: Pathology
    • CN X: Vagal Nerve
    • Colloid Cyst
    • Coma
    • Complete Basilar Syndrome
    • Compression Fracture
    • Concussion
    • Congestive Heart Failure
    • Congenital Muscular Dystrophy / Walker-Marburg
    • Corneal Ulcer
    • Corpus Callosum Disconnection Syndromes
    • Corticobasal Degeneration
    • CST: Corticospinal Tract
    • Craniopharyngioma
    • Craniosynostosis
    • CRPS: Complex Regional Pain Syndrome / Reflex Sympathetic Dystrophy
    • CSF Leak
    • CY-P450 Drugs
    • DAI: Diffuse Axonal Injury
    • Dandy Walker / Dandy Walker Variant / Mega Cisterna Magna / Posteriro Fossa Arachnoid Cyst
    • DAVF: Dural Arteriovenous Fistula
    • DCML: Dorsal Columns Medial Lemniscus
    • Dejerine - Roussy / Thalamic Pain
    • Delirium
    • Dementia
    • Dementia Pugilistica
    • Denervation Hypersensitivity
    • Dermal Sinus Tract
    • Dermoid Cyst
    • Developmental Ventricle Abnormalities
    • Devic's / Neuromyelitis Optica
    • DPL: Diagnostic Peritoneal Lavage
    • DIC: Diffuse Intravascular Coagulation
    • DIG: Desmoplastic Infantile Ganglioglioma
    • DIPG: Diffuse Infiltrative Pontine Glioma / Pontine Glioma / Brainstem Glioma
    • Diphtheria
    • DISH: Diffuse Idiopathic Skeletal Hyperostosis
    • DNET: Dysembryoplastic Neuroepithelial Tumor
    • Dopamine
    • DVST: Dural Venous Sinus Thrombosis
    • Duret Hemorrhage
    • Dystonia
    • ECA Stenosis
    • Eclampsia
    • Ectopic Neurohypophysis
    • EDH: Epidural Hematoma
    • EEG / Sleep
    • Electrolytes -Ca, P
    • Embolic Stroke
    • EMG: Electromyogram
    • Encephalopathy
    • Encephaloceles / Cephalocele
    • Empty Sella Syndrome
    • Enteric Nervous System
    • Enterogenous Cyst
    • Enuresis
    • Ependymoma / Ependymoblastoma
    • Epidural Abscess
    • Epidermoid Cyst
    • Epidural Lipomatosis
    • Esthesioneuroblastoma
    • Ethics
    • Ewing's Sarcoma
    • Fahr's Disease
    • Failed Back Syndrome
    • Familial Periodic Paralysis
    • Fat Embolism
    • Fibrous Dysplasia
    • Fibromuscular Dysplasia
    • Foix Syndrome
    • Folate / Methionine / Homocysteine / Vitamin B 12
    • Foramen Magnum Meningioma
    • Foster Kennedy Syndrome
    • Fracture - Dislocation
    • Freidrich's Ataxia
    • Frontal Sinus Fracture
    • FSH / LH
    • Fungus
    • GABA
    • Gait
    • Ganglioglioma / Gangliocytoma
    • Garcin's Hemibasal Syndrome
    • GBM: Glioblastoma Multiforme
    • Gemistocytic Astrocytoma
    • Germ Cell Tumors
    • Germinal Matrix Hemorrhage
    • Giant Arachnoid Granulations
    • Giant Cell Pituitary Granuloma
    • GI Bleed
    • Gliomatosis Cerebri
    • Gliosarcoma / Feigin Tumor
    • Glutamate
    • Glycine, Renshaw Cell
    • Glycogen Storage Diseases
    • Gradenigo's Syndrome
    • GH: Growth Hormone
    • Gunshot Wound
    • Hallervorden-Spatz
    • Headache
    • Head Injury
    • Hemangioblastoma / VHL: Von Hippel Lindau
    • Hemangiopericytoma
    • Heme Drugs
    • Hemiballismus
    • Hemifacial Spasm
    • Hirschsprung's
    • High Intracranial Pressure
    • Histology Stains
    • HMSN: Hereditary Motor Sensory Neuropathies / Onion Bulb / Hypertrophic / Peroneal muscular atrophy
    • HNP: Herniated Nucleus Propopus
    • Holoprosencephaly
    • Horizontal Gaze
    • HTN: Hypertension
    • Huntington's Disease
    • Hydrancephaly
    • Hydromyelia
    • Hyperostosis Frontalis
    • Hypothalamic Hamartoma
    • Hypothermia
    • Hypothyroid
    • ICA - Persistent Fetal Circulation
    • ICP Monitoring
    • Immunohistochemistry
    • Infectious Vasculitis
    • Intracranial HYPERtension / Pseudotumor Cerebri
    • Intracranial HYPOtension
    • IVH: Intraventricular Hemorrhage
    • Ion Channels
    • IPH: Intraparenchymal Hemorrhage
    • Irregular Central Breathing
    • Ischemic Pathology
    • Ischemic Stroke
    • Isolated 4th Ventricle
    • Jacod's Syndrome
    • JPA: Juvenile Pilocytic Astrocytoma
    • Jugular Foramen Syndromes: Vernet, Collet-Sicard, Villarett
    • Jump Facet
    • K: Potassium
    • Kawasaki
    • Kernicterus
    • Kippel-Trenaunay-Weber
    • Klippel-Fiel
    • Lacunar Stroke
    • Lambert Eaton
    • Landau-Kleffner
    • Langerhan's Histiocytosis X
    • Lateral Recess Syndrome
    • Leber Hereditary Optic Atrophy
    • Leprosy
    • Lesch-Nyhan Syndrome
    • Leukodystrophies
    • Lewy Body Dementia
    • Lhermitte-Duclos
    • Lipoma
    • Lipomyelomeningocele
    • Lissencephaly
    • Locked In
    • Low Grade Diffuse Astrocytoma / Fibrillary Astrocytoma
    • Lowe Syndrome (Oculo-Cerebro-Renal Syndrome)
    • Luckenschadel
    • Lumbar Degenerative Disease
    • Lupus / SLE
    • Lymphocytic Hypophysitis
    • Lysosomal Storage Diseases
    • Malignant Hyperthermia
    • Maple Syrup Urine Disease
    • Mannitol
    • Median Nerve: Carpal Tunnel Syndrome
    • Medulla
    • Medulloblastoma
    • Melatonin
    • MEN: Multiple Endocrine Neoplasia
    • Menke's Kinky Hair Disease
    • Meniere's Disease
    • Meningioma
    • Meningitis
    • Meningioangiomatosis
    • Metastasis
    • Methanol Poisoning
    • Microglia
    • Micturation Syncope
    • Mg: Magnesium
    • MG: Myasthesnia Gravis
    • MI: Myocardial Infarction
    • Mitochondrial Diseases
    • Mononeuritis Multiplex
    • Moya Moya
    • MRI - Study for Disease
    • MS: Multiple Sclerosis
    • MTS: Mesial Temporal Sclerosis
    • Mucopolysaccharidases
    • Multiple Myeloma / Plasmacytoma
    • Muscular Dystrophy
    • Musculocutaneous Nerve
    • Multi-Infarct Dementia
    • Myotonic Dystrophy / Myotonia
    • Myositis
    • Na: Hyponatremia
    • Na: Hypernatremia
    • NAHT: Non-Acciddental Head Trauma
    • Narcolepsy
    • NCS / EMG Examples
    • NCS: Nerve Conduction Studies
    • NE: Norepinephrine
    • Necrotizing Fascitis
    • Neuroepithelial Cyst
    • Neurofibroma / MPNST: Malignant Peripheral Nerve Sheath Tumor
    • Neuroleptic Malignant Syndrome
    • Neuropathy
    • NF1: Neurofibromatosis Type I
    • NF2: Neurofibromatosis Type 2
    • Nisseria Meningitis
    • Nocardia
    • Nodular Heterotopia
    • NPH: Normal Pressure Hydrocephalus
    • Nystagmus
    • O-C1
    • Occipital Neuralgia
    • Olfactory Groove Meningioma
    • Oligodendroglioma
    • Oligodendrocytes
    • Olivopontocerebellar Atrophy
    • Opioids
    • OPLL: Ossified Posterior Longitudinal Ligament
    • Optic Glioma
    • Orbit
    • Orbital Pseudotumor
    • Osteochondroma
    • Osteogenesis Imperfecta
    • Osteoid Osteoma
    • Osteoma
    • Osteomyelitis
    • Osteopetrosis
    • Osteosarcoma
    • Otalgia
    • Oxygen
    • OWR - HHT: Osler Weber Rendu / Hereditary Hemorrhagic Telangiectasia
    • Palatopharyngeal Paralysis of Avellis
    • Paget's Disease
    • Pancoast Tumor
    • Paraganglioma / Glomus Jugulare / Chemodectoma
    • Paramedian Diencephalic Syndrome
    • Paraneoplastic Syndromes
    • Paraneoplastic Limbic Encephalitis
    • Parasites
    • Parietal Foramina
    • Parietal Lesion
    • Parkinson's Disease
    • Parsonage-Turner
    • Pars Fracture
    • PCom Aneurysm
    • PE: Pulmonary Embolism
    • Pediatric Stroke
    • Peds Specific Vitals, Fluids, Blood Volume
    • Perineuroma
    • Peripheral Nerve
    • Periventricular Leukomalacia
    • Pick's Disease
    • Pineal Cell Tumors
    • Pineal Cyst
    • Pituitary Adenoma
    • Pituitary Apoplexy
    • Posterior Vertebral Body Scalloping
    • Pons
    • Pupillary Light Reflex
    • PNA: Pneumonia
    • PNET: Primitive Neuroectodermal Tumors
    • Poisons
    • Polyarteritis Nodosa
    • Polymicrogyri
    • Porencephaly
    • Postherpetic Neuralgia
    • PCA: Posterior Cerebral Artery
    • PRES: Posterior Reversible Encephalopathy Syndrome
    • Pressors
    • Primary Autonomic Insufficiency
    • Prions
    • Progressive Supranuclear Palsy
    • Prolactin
    • Protoplasmic Astrocytoma
    • Pseudolaminar Necrosis
    • Psych Drugs
    • PXA: Pleomorphic Xanthoastrocytoma
    • PTX: Pneumothorax
    • Pulmonary Edema
    • Radiation Necrosis
    • Raeder's
    • Rasmussen's Encephalitis
    • Rathke's Cleft Cyst
    • Respiratory Meds
    • Retinitis Pigmentosa
    • Retinoblastoma
    • Rexed Laminae
    • Rhabdomyolysis
    • Right Heart Failure
    • Rubrospinal Tract
    • Sacral Agenesis / Caudal Regression
    • Sacral Fractures
    • Sacral Meningocele
    • Sarcoidosis
    • Schizencephaly
    • Schwannoma
    • Schilder's
    • Scoliosis
    • Saethre-Chotzen
    • SAH: Subarachnoid Hemorrhage
    • SDH: Subdural Hematoma
    • SEGA: Subependymal Giant Cell Astrocytoma
    • Seizures
    • 5HT: Serotonin
    • Sheehan's Syndrome
    • Shock
    • Shunt Malfunction / Infection
    • Shy Drager
    • Sinus Pericranii
    • Skull Fracture
    • SMA: Supplementary Motor Area Syndrome
    • Spasticity
    • Speech
    • Spina Bifida / Neural Tube Defect
    • Spinal Cord Injuries
    • Spinal Cord Stroke
    • Spinal Epidural Abscess
    • Spinal Epidural Hematoma
    • Spinal Muscular Atrophy (SMA)
    • Spine Anatomy - Degenerative Disease
    • Spine Aneurysms
    • Spine Fractures
    • Spine Vasculature
    • Spinobulbar Muscular Atrophy / Kennedy's Disease
    • Spinoreticular
    • Spinal Tectal Tract
    • Split Cord Malformation / Diastematomyelia
    • Strep Pneumoniae
    • Striatonigral Degeneration
    • STT: Spinothalamic Tract
    • Sturge-Weber Syndrome
    • Subclavian Steal
    • Subdural Empyema
    • Subependymoma
    • Sural Nerve Biopsy
    • Stargardt's Disease
    • Stevens Johnson
    • Stiff Man Syndrome
    • Stimulants
    • Syncope
    • Synovial Cyst
    • Syphillis
    • Syrinx / Synringomyelia
    • Statistics
    • Takayasu's Arteritis
    • Taste: CN VII, IX, X
    • TectoSpinal Tract
    • Temporal Arteritis
    • Tetanus
    • Thoracic Outlet Syndrome
    • Thoracic Spondylosis
    • Thrombotic Stroke
    • Thyroid
    • TIA: Transient Ischemic Attack
    • Tethered Cord
    • TORCH
    • TIMI Score
    • Spinous Process Fracture / Transverse Process Fracture
    • TPN: Total Parenteral Nutrition
    • Traumatic IPH
    • Traumatic Neuroma
    • Trigeminal Neuralgia
    • Trigeminal Neuropathic Pain
    • TS: Tuberous Sclerosis
    • Tolosa-Hunt
    • Transfusion Reaction
    • Tremor
    • Ulnar Nerve
    • Ultrasound
    • Upper Extremity Exam / Brachial Plexus
    • Uremic neuropathy
    • Vagoglossopharyngeal Neuralgia
    • Vertebral Basilar Insufficiency
    • Vertical Gaze
    • VOGM: Vein of Galen Malformation
    • VOR: Vestibulo-Ocular-Reflex
    • Venous Air Embolism
    • Vestibulospinal Tract
    • Ventilator
    • Viruses
    • Eye / Retina
    • VWD: Von Willebrand's Disease
    • Wegener's Granulomatosis
    • Whipple's Disease
    • Wilson's Disease
    • Wormian Bones
    • Wound Healing
    • Wyburn - Mason
    • Zollinger-Ellison
  • Questions

Questions


QUESTIONS

TUMOR
  • Tumor w/ MRI + T1 low, T2 high, restricted diffusion

  • Most common intracranial tumor a/w NF1

  • MR spectroscopy ratio for tumors

  • Oligodendroglioma MRI features


GBM
  • vs. radiation necrosis - dx
  • His
  • Immuno



  • Temporal cyst, displaces arteries & nerves, near basal cisterns

  • Seizures, cystic mesial temporal lobe T1 dark, T2 bright, mild enhancement

  • Most common mets to brain

  • Choroid plexus papilloma location in adults

  • Multiple meningiomas a/w

  • CPA - rad tumor differential







  • Ependymal enhancement, nodular, irregular

  • Fibrous dysplasia Rad


  • MENS




  • Stalk vs. Hook effect in prolactinoma dx






  • BCNU / carmustine - unique SE

  • Meningioma - common chromosomal abnormality
    Most aggressive types
    Immunochemistry

  • Cushing's disease vs. Cushing's syndrome - dx


  • Tumors a/w NF-2


  • Germ cell tumors: lab differentials, hist






  • Immunohistochemistry Stains

  • Epidermoid

  • Optic glioma

  • Low NAA, = Cr, High Choline

  • Calcification, hemorrhage, cystic, T1 heterogeneous, mild enhancement

  • FDG PET (+ in GBM, recurrent tumor). Hypometabolism in radiation necrosis.
  • Glomeruloid vascular proliferation, pseudopalisading cells
  • GOF: 7, 20
  • Loss of allele: 10p, 10q, 9p, 19q

  • Arachnoid cyst

  • Ganglioma


  • Br > Lu > Kd > Melanoma

  • Fourth ventricle

  • NF2

  • VS - heterogenous enhance, IAC extension
  • Meningioma - homogenous enhance, dural tail
  • Cysts - epidermoid (restricted diffusion), dermoid / lipoma (fat suppression)

  • CNS Lymphoma

  • Sclerosis, T1/T2 dark, variable enhancement, +/- cystic

  • I: pancreas, pituitary, PTH
    II: PTH, pheochrom, medullary thyroid
  • III: pheochrom, medullary thyroid, mucosa neuromas

  • Stalk effect: compression on stalk --> decreased dopamine --> no inhibition on prolactin --> mild elevation (25-150)
  • Hook effect: so much prolactin that Ab/prolactin completely bound. Need to dilute 1: 100. 

  • Pulmonary fibrosis / interstitial fibrosis

  • Monosomy 22
  • RAP: rhabdoid, anaplastic, papillary
  • Vimentin, desmosome

  • Cushing's disease: responds to HIGH dexamethasone test, metapyrone

  • schwannoma, meningioma, ependymoma, astrocytoma - NOT neurofibromas

  • Germinoma: PTAH (clear cells, granulomatous inflam, lymphocytes)
  • Teratoma: AFP, CEA
    Yolk sac: AFP (Schilar Duval)
    Chorio: HCG (syncytiotrophoblasts)
    Embryonal: all



  • VHL: tumors a/w
  • Hemangioblastoma w/ abnormal CBC




  • Paraganglioma - his



  • Paget's disease a/w


  • MPNST - affects which CN

  • Pituitary adenoma: vs hyperplasia

  • Staghorn vasculature - tumor

  • Vestibular schwannoma - BAERs abnormalities















  • Cerebellar hemangioblastoma, retinal hemangioma, paraganglioma, pheochromocytoma, RCC, cysts, endolymphatic sac tumors
  • Polycythemia vera

  • Susentacular cells: S100+
  • Chief cells: synaptophysin, chromagranin A, neurofilament

  • TN, peripheral neuropathy, hypopit, osteogenic sarcoma

  • CN V

  • Pituitary hyperplasia + reticulin

  • Hemangiopericytoma

  • Wave I, 2, 3 (AC SLIM)
















VASCULAR
  • Cavernous malformations - MRI, Angio, inheritance
  • Cav mal vs. AVMs


  • Dural AVF - 
    Spinal Type 1: tx

  • Intracranial DAVF - indication for tx

  • SAH - perimesencephalic management
  • Lindegaard ratios account for
  • Vitrous hemorrhage a/w SAH



  • ICA artery a/w tentorial meningiomas & AVMs

  • Dissection / pseudoaneurysm tx

  • Persistent fetal circulation - connects X to vertebral basilar system





  • Amaurosis fugax, polymyalgia rheumatica, HA, 60s - dx

  • How to prevent optic nerve damage when opening for ophthalmic artery aneurysm clipping













  • GRE, Angio neg +/- vascular blush, AD
  • Cav mal - NO intervening brain vs. AVM - intervening brain

  • Embolization

  • Retrograde cortical venous drainage

  • Angio, cardiac/electrolyte, HCP monitoring. No need for vasospasm watch
  • LR: hyperremia vs. vasospasm
  • Terson's syndrom


  • Tentorial / Italian / Bernasconi & Cassinari

  • Anticoagulation

  • Fetal PCA: Pcomm -> PCA
    PTA: Cavernous ICA
    Otic: Petrous ICA
    Hypoglossal: Cervical ICA
    Proatlantal: ICA/ECA

  • Temporal arteritis

  • Early release of falciform ligament














SPINE
  • Spinal Ependymomas - most common location, a/w


  • Enhancement post HLD






  • Basilar invagination lines


  • Vertebral body collapse, lytic with no sclerosis

  • Asthma pt on chronic steroids or obese pt w/ lumbar stenosis, T2 bright dorsal lesions

  • Polka dot sunburst vertebral body

  • Atlanto-occipital dissociation - types of occiput displacement




  • Jump facet MoA

  • Discs - types of collagen


  • Most common location spinal meningioma

  • Hangman's fracture - MoA

  • Klippel-Fiel - abn a/w


  • Lumbar spine w/ pain @ night, alleviated by ASA

  • Spinal cord injuries - methylpred dose









  • Cervical spine
    NF-2

  • Indicates granulation
    • If rim enhanced --> reherniated disc
    • If grossly enhanced --> scar or chronic reherniated disc with capillary ingrowth

  • Odontoid tip > McRae or Wackenheim. >4.5 mm McGregor, >6 mm Chamberlain

  • Eosinophilic granuloma

  • Epidural lipomatosis


  • Hemangioma

  • Type 1: anterior
    Type II: vertical >2mm
    Type IIb: + C1-2 laxity
    Type III: posterior

  • Hyperflexion

  • Nucleus propulsus - Type II
  • Annulus fibrosis - Type I

  • Thoracic spine

  • Hyperextension

  • Sprengel's deformity, Chiari I, basilar impression, GU abnormalities

  • Osteoid osteoma

  • 30 mg/kg x 15 min, then 5.4 mg/kg/hr x 23 hrs









FUNCTIONAL
  • Dejerine & Roussy: thalamic nuclei affected, DBS target


  • Dystonia: DBS target




















  • VPL / ViM (medial lemniscus/STT)
  • Periaqueductal gray

  • CL GPi or VL thalamus





















VENTRICLES
  • Low pressure HA after LP. MRI + leptomeningeal enhancement & thickening

  • Colloid cyst - derived from which type of cells

  • Septum pellucidum, T1 Isointense, mild enhancement

  • Only non-enhancing ventricular tumor
  • Islands of blue in sea of pink

  • Vulnerable areas of hemorrhage in premies vs. full term

















  • Intracranial hypotension


  • Endoderm

  • Central neurocytoma

  • Subependymoma


  • Germinal matrix vs. choroid plexus


















PEDIATRICS
  • 12M, CN deficits, T2 diffuse pontine lesions

  • HCP, cerebellar sx w/ midline enhancing posterior fossa lesion

  • Infant w/ seizures & bilateral basal ganglia calcifications

  • Fused thalami, monoventricle, peripheral rim of undifferentiated cerebral tissue, craniofacial abnormalities, polydactyly, trisomy 13

  • Small, agyric brain, thin cortical mantle, BL calcification, atrophy, HCP in infant

  • Parietal foramen tx


  • Maternal RF for caudal regression

  • Spina Bifida - phase of defect

  • Dandy walker malformation - most common non-CNS anomalies



  • Choroid plexus papilloma - most common location in kids

  • Chiari II malformation a/w which bone abnormalities: 

  • Kernicterus - loc


  • Opsoclonus, myoclonus, encephalopathy
  • Tumor origin
  • Amplified gene

  • Aperts vs. Crouzon's
  • Craniosynostosis defects









  • Precocious puberty, gelastic seizures - dx






  • Infiltrating astrocytoma

  • Medulloblastoma

  • CMV

  • Alobar holoprosencephaly


  • TORCH


  • None. If risk for mechanical injury or >4 yo for cosmesis, cranioplasty

  • Gestational DM

  • Secondary neurulation

  • Cardiac



  • Lateral ventricle (left)

  • Luckenschadel

  • GP, thalamus, subthalamus, dentate nucleus

  • Neuroblastoma
  • Adrenal glands
  • N-myc

  • Both: AD, frontoethmoid synostosis, FGF-R mutation
  • Aperts: MR. Crouzon's: more common
  • Tower skull = Oxycephaly
    Clover shaped = Kleeblattschadel

    Metopic = Trigonocephaly
    BL lamboid or coronal = Brachiocephaly
    UL lamboid or coronal = Plagiocephaly
    *Sagittal = Dolichocephaly / Scaphocephaly

  • Hypothalamic hamartoma







TRAUMA
  • DAI - areas involved


  • MRI age of blood



  • Square ACA sign 

  • GI bleeds a/w closed head injuries

  • Petechiae chest/shoulders, SOB/tachy, stroke, after fracture

  • SDH - predictor of expansion

  • Duret hemorrhage - MoA


  • Central irregular breathing - patterns / locations




















  • brainstem, deep white matter, corpus callosum, thalamus

  • IB, ID, BD, BB, DD.
  • Extracellular x 3, Intracellular.
  • Ox, Deoxy, Meth x2, Hemosiderin

  • Subfalcine herniation, from temporal lobe

  • Cushing's ulcer

  • Fat embolism

  • Pseudomembrane hemorrhage

  • High ICPs / herniation --> pontine perforator stroke / hemorrhagic conversion

  • Cheyne Stokes - BL cerebral
    Central neurogenic: midbrain
    Apneustic: pons
    Cluster: pontomedullary
    Ataxic / biot: medulla
    Odine's curse: cervicomedullary















CRITICAL CARE
  • high K: tx w/ symptomatic EKG changes

  • U waves, muscle weakness, AMS
  • Peak T, prolonged PR interval, QTC
  • Torsades de pointes, a/w other electrolyte abn
  • Hemolytic anemia, decreased CO, decreased tissue O2 availability
  • Hyperreflexia, tetany
  • Cerebral edema, seizures, encephalopathy

  • SVT tx

  • SIMV - settings and variability


  • PE - EKG


  • 2 arrhythmias tx'd with IV Mg

  • Cardiac tamponade - Beck's triad


  • Transfusion reactions: Acute hemolytic vs. non-hemolytic - MoA
  • Irradiated blood prevents

  • VWF - lab abnormalities, Tx



  • Shock - normal values




  • Shock - describe






  • Acid base: normals, compensations
  • early vs. late septic shock
  • most common 2 disorders a/w trauma





  • CSW vs. SIADH
  • Dx
  • Correction rate
  • Complication if too quick
  • Free Na deficit
  • Tx


  • DI - free H20 deficit

  • Anesthetics
    -tension pneumocephalus, increase CBF, CMRO2
    -increase CBF, disrupt autoregulation
    -Increases seizure threshold
    -reduces CMRO2, increases CSF absorption
    -Reduces CBF, ICP, cortisol production
    -Uncouples CBF, CMRO2
    -Most reduction in CMRO2

  • Pressors - alpha/beta proportions






  • ARDS criteria



  • Acute phase reactants - increased during inflammation

  • Best indicator of adequate tissue perfusion

  • MI: tx, Indications for IV TPA


  • Nitroprusside toxicity & tx


  • Ca gluconate

  • HypoK
  • HyperK
  • HypoMg
  • HypoP
  • HypoCa
  • HypoNa

  • Vagal maneuver, adenosine

  • set volume & rate, synchronized to pt's breath with ability to breath over vent

  • Sinus tachy, T wave changes > S1 wide, Q3 long, T3 inverted

  • Torsades de Pointe, MAT

  • Hypotension, JV distension, muffled heart sounds

  • Abs vs ABO vs. leukocytes
  • Graft vs. host disease

  • Long PTT, BT
  • Cryoprecipitate (Factor VIII, VWF), desmopressin (increases release of VWF)

  • CVP 3-8
    CI 2.5-4
    PCWP 6-12
    SVR 900-1200

  • All low: neurogenic
  • All low, except high SVR: hypovolemic, anaphylactic, late sepsis
  • High CVP, PCWP, SVR, low CI: cardiogenic
  • Low SVR, high CI: sepsis

  • Normal: pH 7.4, pCO2 40, HCO3 24
  • Resp alkalosis/acidosis: 0.008(PCO2+/-40)
  • Met alkalosis: 0.7(HCO3) +20 +/-2
  • Met acidosis: 1.5(HCO3) +8 +/-2
  • Early sepsis: respiratory alkalosis
  • Late sepsis: metabolic acidosis
  • Trauma: resp/metabolic alkalosis

  • Both: Na <135, sOsm <280 (low)
    CSW: hypovolemic, UNa >20
    SIADH: eu/hypervolemia, uOsm>sOsm
  • <12 mEq/L / day
  • CPM
  • TBW (125-Na)
  • Tx: SIADH - fluid restriction, 3%, demeclocycline, hemodialysis

  • TBW (Na -140) / 140


  • Nitrous oxide
    Halothane
    Methohexital, enflurane
    Fentanyl
    Etomodate
    Barbituates
    Sodium Thiopental

  • Beta 1: dopamine low
    Beta 1 = Beta 2: epinephrine low, dobutamine, isoproterenol
    Beta 1 = Alpha 1: dopamine mod, NE
    Alpha 1: phenylephrine, dopamine high
    All: epinephrine high

  • BL pulmonary infiltrates
  • PaO2/FiO2 <200
  • PCWP <18

  • CRP, fibrinogen, haptoglobin

  • GI pH

  • MONAB, TPA if CP >30 min <12h, no CHF or hypotension

  • Toxicity: delirium, abd pain, SOB, n/v
  • Tx: methylene blue


  • Succinylcholine a/w increase in which electrolyte

  • Thyrotoxicosis after iodine contrast in pt w/ toxic nodular goiter

  • DIC - labs


  • Urinary retention - central coordination site, MoA in cauda equina, Tx


  • HyperCa - tx


  • TPN -  acid-base disorder, other SE



  • Coumadin - factors inhibited, reversal tx

  • Conn syndrome - sx


  • Tension PTX - tracheal deviation, tx


  • After induction, acute onset increase end tidal CO2, skeletal muscle rigidity, fever - dx & tx

  • ARF: 
    Leukocyte casts
    Epithelial casts

  • Thiazide diuretics - MoA











  • K

  • Jodbasedow effect

  • High: PT, PTT, D-dimer
    Low: fibrinogen, platelets

  • Pontine micturation center, Detruser atonic, Bethanecol

  • NS, lasix, calcitonin, bisphosphonate, dialysis

  • Hyperchloremic metabolic acidosis, hepatic cholestasis, low vitamins/minerals/fatty acids, high volume/glucose

  • Factors II, VII, IX, X, proteins C, S

  • HTN, hypernatremia, metabolic alkalosis, hypokalemic, hypoMg

  • Away from PTX, emergent needle thoracocentesis --> thoracostomy

  • Malignant hyperthermia from succinylcholine. Tx: dantrolene

  • AIN
    ATN


  • Distal convoluted tubule. Rids Na, K. Resorbs Ca, uric acid, lipids.











NEUROLOGY
  • TS: Tuberous sclerosis inheritance pattern, MRI brain findings


  • HSV appearance on MRI


  • GPi hypodensity on CT

  • MTS (mesial temporal sclerosis) PET

  • NF1 dx, genetics




  • Best AEDs and seizure types






  • Barbituates - MoA, T1/2




  • Poisons - name disease & tx: 
    Sx: Hypochromic anemia. Gingivostomatitis/psych. Cardiomyopthy/pancytopenia/hypotensive shock. 
    Txs: Fe, Lead in children, Wilson's, Manganese, Arsenic

  • Vitamin to prevent peripheral neuropathy in isoniazid pts

  • Lowers seizure thresold - antiemetic

Histology bodies 
  • Ubiquitin
  • P-Tau
  • Lewy body components
  • Opalsky, Alzheimer's II
  • Bunina bodies
  • Polyglucosans
  • Hirano bodies: diseases


  • Neurosarcoidosis affects which CN, type of granuloma


  • Alzheimer's disease - Loc, Sx





  • ALS - AD gene
  • sx
  • pr
  • a/w

  • Multiple sclerosis: HLA

  • Sturge Weber: inheritance patterm

  • Mucopolysaccharidases: Hunter vs Hurler's


  • Ischemia - vulnerable locations



  • Hemiballismus - MoA, NT abnormality, Tx


  • MG: myasthenia gravis - dx


  • Fe in GP, Snr, MRI eye of the tiger: dx, gen

  • AD, 80% penetrance, SEGA, subependymal nodules, cortical tubers

  • Temporal lobe - T2 bright, contrast enhancing

  • Carbon monoxide poisoning

  • High during seizures, low interictal

  • 6 cafe au lait, axillary freckling, 2 neurofibroma (or 1 plexiform), optic glioma, 2 lisch nodules, sphenoid dysplasia, relative w NF1. AD, 100% penetrance

  • GTC: pheytoin
    CPS: carbamezepime 
    Lennox-Gaustault: valproic acid
    West: ACTH
    Absence: ethosuccimide (valproic if GTC)
    Neonatal: phenobarbital 

  • Increase CBF, cerebral perfusion. Uncouples flow w/ metabolism --> decrease CMRO2. Shunts blood from normal to ischemic brain. T1/2 100 hrs

  • Sx: Lead, Mercury, Arsenic
  • Tx: Deferoxamine, succimer, pennicillamine, L-Dopa, BAL


  • Vitamin B6 / pyridoxine

  • Phenergan

  • Ubiquitin: bunina, marinesco, Lewy body, Pick
  • P-Tau: Pick, neurofibrillary tangles, plaque
  • Lewy body: ubiquitin, a-synuclein, aB crystallin, neurofilaments
  • Wilson's disease
  • ALS
  • Lafora bodies
  • Alzheimer's Pick

  • CN VII
  • Non-caseating granuloma

  • Hippocampus, frontal (spares occipital and motor cortex)
  • Forgetfulness / auditory hallucinations (in elderly)

  • SOD
  • UMN, LMN in UE, speech, swallow
  • Fatal in 3-5 yrs
  • parkinson's

  • HLA A3, B7, DR 2, 3, 15

  • Sporadic

  • Hunters: X linked, less MR
  • Hurler's: Ar, corneal clouding

  • Hippocampus (CA1>CA3), cortex 3, 5, 6, watershed, basal ganglia, cerebellum Purkinje cells 

  • Subthalamic nucleus infarct, no glutamate (from STN to GPi/SNr), dopamine.

  • ACh Ab, MUSK, weak w/ stimulation, Tensilon +

  • Hallervorden-Spatz: spor, Ar PANK2, ch 20

  • EOMI, but no accomodation, facial weakness, ascending paralysis - dx

  • Muscular dystrophies: Duchenne gen

  • Difference btw polymyositis & dermatomyositis



  • Homocystinuria - high/low/tx


  • Huntington's - chrom abn, gen, repeat, loc, pathway affected


  • Lysosomal storage diseases: 
  • Gaucher's: deficiency


  • Leukodystrophy
  • aspartocytase deficiency + subcortical U fiber involvement

  • HMSN: Refsum's deficiency

  • Abdominal pain/diarrhea, fever/tachy/HTN, acute paranoia - Dx, Tx



  • Alcohol: Korsakoff defect location

  • Painful ophthalmoplegia, CN palsies - dx, loc, MoA


  • Stroke in nucleus ambiguous (cephalad portion) - sx

  • Jugular foramen syndromes - DDx



  • Can't write, count, tell fingers or R/L apart

  • Mitochondrial disease NOT from maternal DNA

  • Glycogen storage diseases - name, type, deficiency





  • Friedreich's ataxia - gen, onset, tracts, other organs


  • Infant w/ extensor spasms: EEG, Dx

  • Sleep waves









  • Narcolepsy: sx






  • Diphtheria

  • X linked

  • Polymyositis: T cells, within muscles, EMG fibrillations
  • Dermatomyositis: B cells @, a/w cancer

  • High: homocystine, methionine
    Low: cystathione B-synthase
    Tx: low proteins, B12, B6, cysteine

  • Ch 4, AD, CAG w/ anticipation, caudate nucleus, indirect pathway

  • Glucocerebrosidase



  • Canavan's


  • Phytanonoyl-CoA hydroxylase

  • AIP: Acute Intermittent Porphyria
    Dx: porphobilinogen deaminase
    Tx: propranolol

  • DM thalamus, mammillary bodies

  • Tolosa-Hunt, lateral wall cavernous sinus, granulomatous inflammation

  • Palatopharyngeal paralysis of Avellis

  • Vernet: 9, 10, 11, IC
  • Collett-Siquard: 9, 10, 11, 12, EC
  • Villarett: 9, 10, 11, 12, SNS, RP

  • Gerstmann's

  • Leigh's (from nuclear DNA)

  • I: Von Gierke's --| glucose 6 phosphatase
    II: Pompe --| lysosomal lactate maltase
    III: Cori's --| debranching enzyme
    V: McArdle's --| myophophorylase
    VII: Tauri's --| phosphofructokinase

  • frataxin gene, GAA repeats, 10-15 yo M, DCML, CST, spinocerebellar. Cardiac.

  • Hysarrhythmia, West syndrome

  • Stage 1: alpha -> slow voltage
    Stage 2: sleep spindles, K
    Stage 3: sleep spindles, K, <50% delta (somnoambulism, night terrors, enuresis)
    Stage 4: >50% delta
    (somnoambulism, night terrors, enuresis, deep sleep)
    REM: diverse, EtOH withdrawal, sleep deprivation, OSA.

  • Starts w/ REM, = total sleep/24h, hypagnogic hallucinations (beginning), cataplexy, paralysis of voluntary muscles except EOMs, low orexin from hypothalamus.













































INFECTIOUS
  • Lacunar infarcts --> gelatinous pseudocyts

  • Asymmetric, periventriclar, white matter w/ subcortical U fiber, parietal-occipital (+/- BG, brainstem, cerebellum), T1/T2 hyperintensities

  • Symmetric, frontal (centrum semiovale) T2 hyperintesity

  • Eccentric target sign

  • Periventricular hyperintensity, FLAIR +

  • Virus a/w CNS lymphoma

  • Cerebral abscess: Stages of formation
    Most common organism




  • Prophylactic tx for peripheral neuropathy a/w isoniazid

  • Meningitis: most common organisms
  • Skull fx
  • Shunt
  • Neonates
  • Infants
  • Adults
  • Elderly

  • C diff - diagnostic test

  • Fungus: southwest dust, endospores inside bigger spore

  • Mucor vs Aspergillis

  • TB: intracranial location

  • Retro-orbital pain, CN VI palsy, draining ear - dx

  • Akinetic mutism - structures involved







  • Cryptococcus

  • PML



  • HIV encephalopathy

  • Toxoplasmosis

  • CMV

  • EBV: Epstein-Barr virus 

  • <1 wk: Early cerebritis: inflammation
    1-2 wk: Late cerebritis: ring enhancement
    2-3 wk: Early capsule: necrotic center
    >3 wk: Late capsule: gliotic capsule
  • Strep milleri

  • Vitamin B6

  • S. pneumoniae 
  • S. epidermidis
  • GBS, Ecoli, Listeria
  • S. pneumo, N. meningitis, H. influenzae
  • S. pneumo, N. meningitis
  • S. pneumo, Listeria, GNR


  • Direct cytotoxic assay

  • Coccidiomycosis

  • Hyphae non-septated vs. septated

  • Basal

  • Gradenigo's

  • RAS, thalamus, hypothalamus, cingulate gyrus







ANATOMY
  • Midline sulci immediately posterior to central sulcus

  • CNS stem-cell locations


  • Cavernous sinus triangles - match artery w/ triangle
    Meningohypophysesal trunk
    Middle meningeal artery
    Petrous carotid




















  • Pars marginalis

  • Hippocampus dentate nucleus, subependymal zone, olfactory lobe

  • Parkinson's/infratrochlear
  • Glascock/posterolateral
  • Kawase's/posteromedial





















SURGERY
  • CPA approach for intracananilicular lesion w/ preserved hearing

  • Sitting position, low end tital CO2 (cough, hypotension, hypoxia) - dx, tx, a/w



  • Wound healing - maximum collagen formation



















  • Middle Fossa

  • Venous air embolism
  • Tx: Hemostasis, irrigate surgical field, lower head, left lateral decubitus, TEE
  • A/w: upright position, open sinus, DBS

  • 2 months