Crack The Core 2 > Brain Development > Flashcards

Brain Development Flashcards

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1
Q

What is the T1 pattern of a baby brain similar to?

A

The T2 pattern of an adult

This similarity is due to myelination changes in the brain.

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2
Q

What is the T2 pattern of a baby brain similar to?

A

The T1 pattern of an adult

This reflects the differences in myelination between infants and adults.

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3
Q

What is the water content of immature myelin compared to mature myelin?

A

Higher water content

Immature myelin appears brighter on T2 and darker on T1 due to this higher water content.

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4
Q

What happens to the water and fat content during the maturation process of myelin?

A
  • Water decreases
  • Fat increases

Mature white matter will be brighter on T1 and darker on T2.

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5
Q

At what age is the adult T1 pattern typically seen?

A

Around age 1

This is part of the myelination timeline in brain development.

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6
Q

At what age is the adult T2 pattern typically seen?

A

Around age 2

This follows the appearance of the adult T1 pattern.

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7
Q

What is the order of myelination progression?

A
  • Inferior to superior
  • Posterior to anterior
  • Central to peripheral
  • Sensory fibers prior to motor fibers

This order is crucial for understanding brain development.

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8
Q

What part of the brain is the last to myelinate?

A

Subcortical white matter

The occipital white matter myelinates around 12 months, and frontal regions around 18 months.

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9
Q

When do the terminal zones of myelination finish?

A

Around 40 months

These zones are located in the subcortical frontotemporoparietal regions.

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10
Q

What is the myelination status of the brainstem and posterior limb of the internal capsule at birth?

A

Normally myelinated

This is an important aspect of brain development at birth.

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11
Q

What is the myelination status of the anterior and posterior pituitary at birth?

A

TI Bright

The anterior pituitary remains TI bright until 2 months.

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12
Q

What is the last part of the brain to myelinate?

A

Cortical white matter

Occipital white matter around 12 months, frontal regions around 18 months.

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13
Q

At what age does frontal lobe myelination typically complete?

A

Around 18 months

This is significant in explaining teenage behavior.

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14
Q

What regions of the brain myelinate around 40 months?

A

Subcortical temporoparietal regions

These regions are involved in various cognitive functions.

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15
Q

True or false: The brainstem is normally myelinated at birth.

A

TRUE

This is a high-yield piece of testable trivia.

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16
Q

What are the two types of pituitary glands and their MRI characteristics at birth?

A
  • Anterior Pituitary: TI bright at birth
  • Posterior Pituitary: TP bright at birth

Anterior Pituitary remains TI bright until 2 months.

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17
Q

How does brain iron change with age?

A

Increases with age

The globus pallidus darkens as brain iron increases.

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18
Q

What is the order of sinus development?

A
  • Maxillary
  • Ethmoid
  • Sphenoid
  • Frontal

Most sinuses are finished forming by around 15 years.

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19
Q

What is the signal characteristic of calvarial bone marrow in younger children?

A

TI hypointense

In older kids, it becomes fatty and TI hyperintense.

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20
Q

What are the five basic categories of congenital malformations?

A
  • Failure to Form
  • Failure to Cleave
  • Failure to Migrate
  • Development Failure Mimics
  • Herniation Syndromes

This categorization helps simplify the complex topic of congenital malformations.

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21
Q

What is a classic point of trivia regarding the formation of the corpus callosum?

A

It forms front to back

The rostrum is formed last.

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22
Q

In hypoplasia of the corpus callosum, what is usually absent?

A

The splenium

The genu is typically intact.

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23
Q

What is colpocephaly?

A

Asymmetric dilation of the occipital horns

It is commonly associated with agenesis of the corpus callosum.

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24
Q

When you see a picture of colpocephaly, what two conditions should you think of?

A
  • Corpus Callosum Agenesis
  • Pericallosal Lipoma

These conditions are often discussed in relation to colpocephaly.

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25
What is **Dysgenesis / Agenesis of the Corpus Callosum** associated with?
* Intracranial Lipoma * Heterotopias * Schizencephaly * Lissencephaly ## Footnote It is considered the most common anomaly seen with other CNS malformations.
26
Where is the **most classic association** of Intracranial Lipoma found?
Interhemispheric fissure ## Footnote 50% of intracranial lipomas are located here.
27
What is the **second most common location** for Intracranial Lipoma?
Quadrigeminal cistern ## Footnote This location accounts for 25% of cases.
28
True or false: **CNS Lipomas** are true neoplasms.
FALSE ## Footnote CNS Lipomas are congenital malformations.
29
What is the **most helpful sequence** for identifying non-bleeding things in the brain?
Non Fat Sat TI ## Footnote Most non-bleeding things in the brain are not T1 bright.
30
What appearance do the **lateral ventricles** have when there is no corpus callosum?
Widely spaced ## Footnote This is due to the presence of Probst bundles running parallel to the interhemispheric fissure.
31
What is the **'steer horn' appearance** associated with?
Coronal imaging of the brain ## Footnote This appearance is noted in cases of Dysgenesis / Agenesis of the Corpus Callosum.
32
What does **'Maldifferentiation of the Meninx Primitiva'** refer to?
A French sounding explanation for frequent pericollasal location ## Footnote This term is often considered meaningless.
33
What is the **common symptom** of Intracranial Lipomas?
Usually asymptomatic ## Footnote These lipomas are rarely treated.
34
What is **Anencephaly**?
Defect at the top of the head; absent cerebrum and cerebellum ## Footnote Not compatible with life; classic image appearance includes a 'Frog Eye' appearance due to absent cranial bone.
35
What is the classic image appearance of **Anencephaly**?
Incredibly creepy 'Frog Eye' appearance ## Footnote This appearance is due to absent cranial bone and brain with bulging orbits.
36
What is the **Neural Tube Defect** at the level of the cervical spine?
Deficient occipital bone with defect in the cervical region ## Footnote Characterized by extreme retroflexion of the head and enlarged foramen magnum.
37
What is the classic image appearance of the **Neural Tube Defect** at the cervical spine?
'Star Gazing Fetus' appearance ## Footnote This appearance is due to hyper-extended cervical spine, short neck, and upturned face.
38
True or false: **Neural Tube Defects** are usually compatible with life.
FALSE ## Footnote Most cases are not compatible with life; when they do survive, they may have a talent for amateur astronomy.
39
What is the significance of **AFP** in open neural tube defects?
AFP will be elevated ## Footnote This is true for all open neural tube defects.
40
What is **Encephalocele**?
Neural tube defect where brain + meninges herniate through a defect in the cranium ## Footnote Most commonly occurs midline in the occipital region.
41
What is a classic association with **Encephalocele**?
Chiari II ## Footnote This condition is one of the numerous associations with encephalocele.
42
What is a secondary sign of **open neural tube defects** observed in antenatal ultrasound?
Polyhydramnios ## Footnote This occurs due to difficulties in swallowing without a brain.
43
What is **Rhombencephalosynapsis** characterized by?
Absence of the vermis and abnormal fusion of the cerebellum ## Footnote Classic image appearance includes a transversely oriented single lobed cerebellum.
44
In **Joubert Syndrome**, what is the classic image appearance of the superior cerebellar peduncles?
**Molar Tooth** appearance ## Footnote This appearance is characterized by elongated structures resembling the roots of a tooth.
45
What are the associations with **Joubert Syndrome**?
* Retinal dysplasia (50%) * Multicystic dysplastic kidneys (30%) * Liver Fibrosis (COACH Syndrome) ## Footnote These associations highlight the spectrum of conditions linked to Joubert Syndrome.
46
What are the two markers of normal **vermian development**?
* Primary fissure * Fastigial point ## Footnote These markers are best seen in mid-sagittal images of the cerebellum.
47
What is the **normal angular contour** of the fastigial point described as?
Normal angular contour (not round) along the ventral surface of the cerebellum ## Footnote This contour is crucial for identifying normal cerebellar morphology.
48
What shape is the **primary cerebellar fissure** described as?
Deep trapezoid shaped cleft along the posterior cerebellum ## Footnote This fissure is a key landmark in assessing cerebellar structure.
49
True or false: The **fastigial point** should be located just below the mid pons.
TRUE ## Footnote Proper positioning of the fastigial point is essential for normal cerebellar anatomy.
50
What is the appearance of the **4th ventricle** in Joubert Syndrome?
**Batwing Shaped** ## Footnote This shape is indicative of abnormalities associated with Joubert Syndrome.
51
What happens to the **pyramidal decussation** in Joubert Syndrome?
Absent ## Footnote This absence is a significant feature in the diagnosis of Joubert Syndrome.
52
What are the **three key findings** consistently present for diagnosing **Classic Dandy Walker**?
* Dilated cystic 4th ventricle * Hypoplastic vermis * Elevated and rotated vermis ## Footnote These findings are essential for a reliable diagnosis of Classic Dandy Walker malformation.
53
What does the **term 'TORCULAR-LAMBDOID INVERSION'** refer to in Dandy Walker malformation?
The torcula above the level of the lambdoid suture due to elevation of the tentorium ## Footnote This inversion is often NOT seen in the 'variant' version of Dandy Walker.
54
What is the most common manifestation of **Dandy Walker malformation** within the first month?
Macrocephaly ## Footnote Nearly all cases present with macrocephaly within the first month.
55
True or false: **Dandy Walker malformations** can be identified on OB screening ultrasound.
TRUE ## Footnote Dandy Walker malformations are often identified during obstetric screening.
56
What are some **associations** with Dandy Walker malformation?
* Hydrocephalus (90%) * Additional CNS malformations (~40%) * Agenesis of the corpus callosum * Encephaloceles * Heterotopia * Polymicrogyria ## Footnote These associations highlight the complexity and potential complications of Dandy Walker malformation.
57
What is the **nonspecific appearance** on axial imaging in Dandy Walker malformation?
Enlarged posterior fossa CSF space ## Footnote It can resemble a retrocerebellar cyst on axial imaging, although it is not a cyst.
58
What happens to the **cerebellar hemispheres** in Dandy Walker malformation?
Displaced forward and laterally while preserving overall volume and morphologic characteristics ## Footnote This displacement is a characteristic feature of the malformation.
59
What symptoms can present due to **increased intracranial pressure** in Dandy Walker malformation?
Symptoms can include macrocephaly and other signs of increased intracranial pressure ## Footnote These symptoms typically manifest prior to the first month of life.
60
What are the **Dandy Walker malformations** typically described along?
A spectrum ## Footnote The classic subtype is covered in depth on the prior page.
61
To call it **classic Dandy Walker malformation**, what must be present?
Specific features ## Footnote Without the other features, it cannot be called a true classic Dandy Walker malformation.
62
What is the **least severe** form of Dandy Walker malformation?
Mega Cisterna Magna ## Footnote This is contrasted with more severe forms on the chart.
63
What is the **most severe** form of Dandy Walker malformation?
"Classic" Dandy Walker malformation ## Footnote This form is characterized by more pronounced features.
64
What is an **alternative term** used to trick you regarding Dandy Walker malformations?
"Hypoplastic Rotated Vermis" ## Footnote This term can be misleading without the context of other features.
65
What is a **normal variant** associated with Dandy Walker malformations?
Focal enlargement of the retrocerebellar CSF space ## Footnote This variant does not indicate pathology.
66
What is the **sac-like cystic protrusion** associated with Dandy Walker malformations?
Protrusion through the foramen of Magendie ## Footnote This protrusion occurs into the infra/retro cerebellar region.
67
What is the **communication** characteristic of the pouch in Dandy Walker malformations?
Communicates only with the 4th ventricle ## Footnote It does not communicate with the cisternal CSF.
68
What is the **diagnosis** timeline for Dandy Walker malformations on antenatal ultrasound?
After 18 weeks ## Footnote Prior to 18 weeks, the vermis has not finished forming.
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