Must-Knows

Question 1

Most common cerebellopontine angle (CPA) tumors

Answer 1

Acoustic neuroma

Meningioma

Question 2

Lesion in frontal eye field vs seizure

Answer 2

Frontal eye field lesion: deviation towards lesion

Seizure: deviation to opposite

Question 3

What does DWI enhances?

Answer 3

Stroke, abscess, epidermoid

Question 4

EDH is associated with what? Crossing sutures and falx?

Answer 4

Associated with skull fracture (and pneumocephalus).

Don’t cross sutures. Can cross falx

Question 5

Operative indication for EDH

Answer 5

Especially > 30 cc

Nonsurgical ok in 8GCS, no deficit (ALL requirements)

Question 6

When to operate for compression fracture?

Answer 6

3 contiguous levels or wedge fracture

Question 7

Where is the tegmen?

Answer 7

Tegmentum typamni - between cranial and tympanic cavities, thin bone

Question 8

What can cause vertebral dissection?

Answer 8

Archery, sneezing, sudden neck movement

Question 9

Gradenigo sign

Answer 9

CN6 palsy, retro-orbital pain, draining ear (mastoiditis spreading along petrous bone and CN6)

Question 10

Annulus of Zinn

Answer 10

Divides components of superior orbital fissure

Question 11

Cavernous aneurysm - typical progression

Answer 11

Fistulize upon rupture, may cause mass effect before

Question 12

PCA runs through what?

Answer 12

Ambient cistern (lateral to the medulla)

Question 13

How do you present a scan on rounds?

Answer 13

This is a , then

Question 14

How do you calculate midline shift?

Answer 14

Use the septum pellucidum

Question 15

Path of CN 3 and 6

Answer 15

Very medial, right over clivus. Also for 4 and 5

Question 16

Decrease ICP can cause what?

Answer 16

Bilateral CN6 palsy

Question 17

Most common site for intraventricular meningioma

Answer 17

Left trigone of lateral ventricle

Question 18

What is the inferior venous drainage for temporal lobe?

Answer 18

Inferior anastomotic vein of labbe

Question 19

Neurosarcoid can present as what?

Answer 19

Multiple cranial neuropathy

Question 20

What are gelastic seizures

Answer 20

hypothalamic seizures caused by hamartoma

Question 21

Sellar lesion differential

Answer 21

SATCHMOL
Sarcoid/pit adenoma
Aneurysm
Teratoma
Craniopharyngioma/RCC/Chordoma
Hamartoma
Meningioma/mets
Optic glioma
Lymphoma

Question 22

Postop transphenoidal triple phase

Answer 22

1) DI due to acute injury
2) cell death cause release and transient SIADH
3) delayed DI

Question 23

Mollaret’s

Answer 23

Epidermoid cysts can give rise to aseptic meningitis

Question 24

Lillequist’s membrane

Answer 24

Separates interpeduncular cisterns from chiasmatic cistern - localizes SAH

Question 25

Transsphenoidal anatomy

Answer 25

Superiorly: circular sinus connects cavernous sinus - site of bleeding
Midline in sphenoid is the rostrum.

Question 26

Subdural membrane

Answer 26

Immune/inflam rxn to chronic blood - why we need to evacuate clot to prevent from reforming a membrane

Question 27

Posterior pituitary on T1

Answer 27

Enhances

Question 28

Mega cisterna magna

Answer 28

Between cerebellum and dorsal surface of medulla oblongata. Large cisterna magna is benign. Ddx include arachnoid cyst.

Question 29

Herniated disc level lateral vs posterolateral vs lumbar stenosis

Answer 29

Posterolateral: level below
Far lateral: level above
Lumbar stenosis: level above