Neuro Case Review

Front 1

Intracranial complications of orbital cellulitis?

Back 1

Cavernous thrombosis
Meningitis
Brain abscess

Front 2

Clinical presentation of orbital pseudotumor?

Back 2

Pain
Proptosis
Ophthalmoplegia (decreased motility)

Front 3

Managment of orbital pseudotumor?

Back 3

Steroids

Front 4

Most common cause of orbital cellulitis?

Back 4

Sinusitis
Dental infection
Penetrating eyelid injury

Front 5

Two most common vascular causes of acute bilateral thalamic lesions?

Back 5

Infarction of the artery of Percheron (a single perforating artery trunk that supplies the paramedian thalamic arteries)

Deep venous thrombosis (internal cerebral veins)

Front 6

3 most common locations of hypertensive bleeds?

Back 6

basal ganglia (especially putamen)

thalamus

pons

Front 7

Segment of the ACA that the medial lenticulostriate arteries arise?

Back 7

A1

Front 8

Structures the recurrent artery of Heubner supply?

Back 8

head and anteromedial caudate nucleus

anterior limb of internal capsule

Front 9

Lateral lenticulostriate arteries arise from which major vessel?

Back 9

MCA

Front 10

How often is metastatic disease to the brain a solitary met?

Back 10

30-50%

Front 11

What type of met is associated with little of no edema such that they are missled on T2w imaging and only seen on gad?

Back 11

Cortical met

Front 12

What extraocular muscle is not involved in isolation in thyroid ophthalmopathy?

Back 12

Lateral rectus

Front 13

What structure runs between the superior rectus muscle and the optic nerve?

Back 13

Superior ophthalmic vein.

Front 14

Differential of a ring-enhancing mass?

Back 14

Primary brain tumor
Met
Pyogenic abscess
Demyelinating disease
Maturing hematoma
Radiation necrosis

Front 15

In utero abnormality that results in Chiari malformations?

Back 15

Neural tube defects - dorsal induction

Front 16

Cervical spine anomalies associated with Chiari II?

Back 16

Klippel-Feil syndrome
partial fusion of C2 and C3
occipitalization of the atlas (C1)
hypoplastic ring of C1

Front 17

Accepted normal limits in children and adults for the inferior position of the cerebellar tonsils relative to the foramen magnum?

Back 17

<10 years - 6mm or less

adult - 3mm or less

Front 18

Signs and symptoms of Parinaud's syndrome?

Back 18

Paralysis of upward gaze
Lid retraction
Abnormal pupillary reactions

Front 19

Anatomic relationship of the pineal gland relative to the velum interpositum?

Back 19

Pineal gland is directly below the splenium of the corpus callosum.

Velum interpositum is rostral and dorsal to the pineal gland and contains the internal cerebral veins, which join to form the vein of Galen.

Front 20

Structures that enhance following IV contrast?

Back 20

Structure without blood-brain barrier
choroid plexus
pituitary stalk
pineal gland
mucous membrane
extraocular muscles

Front 21

How do you distinguish pilocytic astrocytoma from hemangioblastoma?

Back 21

JPA present <20years

Hemangioblastomas >20years

Abnormal vessels/ vascularity

Front 22

Disorder associated with pilocytc astrocytomas involving the visual pathway?

Back 22

NF 1

Front 23

Most common extraskeletal manifestation in this disorder?

Back 23

Cutaneous pigmentation (cafe-au-lait spots)

Front 24

Lab abnormality often seen in fibrous dysplasia and Paget's?

Back 24

high serum alkaline phosphatase

Front 25

Clinical manifestations of McCune-Albright syndrome?

Back 25

Form of polyostotic fibrous dysplasia that occurs in girls and is typically associated with precocious puberty and cutaneous hyperpigmentation

Front 26

Which bones are most commonly affected in polyostotic fibrous dysplasia?

Back 26

Skull and facial bone (as well as the pelvis and spine)

Front 27

What is Balo's concentric sclerosis?

Back 27

Uncommon demyelinating disorder characterized on MR as lesions with a laminated appearance that reflect alternating regions of demyelinated and myelinated tissue

Core is more similar to CF

Front 28

Pathologic hallmark of an acute, active demylinating plaque?

Back 28

perivenual inflammatory changes

Front 29

Percentage of patients with MS has isolated spinal cord disease?

Back 29

10%

Front 30

What is Devic's disease?

Back 30

Involvement of the spinal cord and / or optic pathways without brain involvement

Front 31

Percentage of meningiomas that calcify?

Back 31

25%

Front 32

% of meningiomas that undergo cystic degeneration?

Back 32

5-10%

Front 33

Findings of subfalcine herniation?

Back 33

herniation of the cingulate gyrus beneath the anterior free edge of the falx

Front 34

Common anatomic variant associated with aneurysms arising from the ACA?

Back 34

hypoplastic A1

Front 35

What time after an acute SAH is symptomatic vasospasm most likely to occru?

Back 35

5-12 days

Front 36

Anerurys arising from what arteries may be associated with an acute-onset pupil involivng third nerve palsy?

Back 36

Posterior comminicating artery

less frequent - superior cerebellar artery

Front 37

3 most common sites for ruptured aneurysms

Back 37

ACA
origin of PCA
MCA

Front 38

Classic clinical presentation of vestibular schwannomas?

Back 38

Sensorineural hearing loss

Front 39

Structure that separates the IAC into the superior and inferior portions?

Back 39

Crista falciformis

Front 40

Bilateral vestibular neuromas are seen with what syndrome?

Back 40

NF2
MISME- multiple idiopathic schwannomas, meningiomas, and ependymomas

Front 41

Imaging findings favoring a schwannoma over meningioma?

Back 41

Involve both the CPA and IAC

Flaring or widening of the porus acousticus (the opening of the IAC)

Absence of dural enhancment

Front 42

3 subtypes of infiltrating astrocytic gliomas?

Back 42

WHO classification
infiltrating (II)
anaplastic
GBM

Front 43

Non-infiltrating gliomas include?

Back 43

pilocytic
subependymal giant cell
pleomorphic xanthoastrocytoma

Front 44

Imaging findings that differeniate an extra-axiam mass from an intra-axial mass?

Back 44

Buckling of gray and whit matter

Broad-based against the dural surfact and inner table of the calvarium

Front 45

Arachnoid cysts are derived from what structure?

Back 45

Meninx primitiva - which is resorbed and CSF fills in

Front 46

Causes of intraocular calcification in children?

Back 46

retinoblastoma

persistent hyperplastic primary vitreous

toxocaral endophthalmitis

Coats' disease (congenital retinal telangiectasia)

retrolental fibroplasia

Front 47

How often are retinoblastomas bilateral?

Back 47

30%

Front 48

Most common clinical presentation of retinoblastoma?

Back 48

Leukocokoria ("white" pupil)