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Uncinate fasciculus
Uncinate fasciculus
WM tract, connects ant. temp. lobe & orbitofrontal cortex
In temporal lobe epilepsy - sz propagation pathway
Sz
Sz
Olfactory hallucinations - classic temp. lobe epilepsy
Fencing posture (SMA sz) - frontal lobe epilepsy
Initial Tx:
ABC
Myotatic reflex
Myotatic reflex
Hammer on patellar tendon → muscle spindle (Ia) of QC → ɣ-motor neurons → static & dynamic fibers contruction → contraction
Pilocytic astrocytoma
Pilocytic astrocytoma
Epidemiology
M = F
MC glioma in children
Rosenthal fibers
eosinophilic, corkscrew-shaped structures; hallmark fi
Biphasic pattern:
loose, myxoid matrix (myxoid stroma) w/ spindle-shaped cells
compact, densely packed areas w/ bipolar cells.
Calcifications
dense, basophilic, granular deposits
Minimal nuclear atypia
GFAP ⊕
Lipoma of corpus callosum
Lipoma of corpus callosum
High T1-signal intensity (similar to fat)
nonenhancing midline masses
Si - ± HA
Tx - Observation
Bone mineral density (DEXA)
Bone mineral density (DEXA)
Z score - hip & vertebral body compared to age-/gender-/ethnicity
T score:
low normal - 0 to -1;
osteopenia - -1 to -2.5;
osteoporosis - -2.6 or ↓
ICA stenosis - Statins Rx
ICA stenosis - Statins Rx
limit progression of plaque
↓ rates of conversion of aSx to Sx dz
↓ x5 in periop. mortality for CEA
goal LDL <100
Chiari Malformations
Chiari Malformations
Chiari Type
Features
0
Syrinx w/o tonsillar herniation
I (MC)
Tonsillar herniation >5 mm (basion-opisthion line)
HCP uncommon
Syrinx common
I.5
Tonsillar herniation w/o syrinx
II
vermis, brainstem & 4th vent. herniation
assoc. w/ MMC & multiple brain anomalies
syrinx & HCP very common
III
Cervical/occipital encephalocele
IV
Hypoplasia/aplasia of cerebellum & tentorium
Carotid-ophthalmic aneurysms → project superiorly
Superior hypophyseal aneurysms → roject inferomedially
GPi stimulation - electrode placement
GPi stimulation - electrode placement
too deep → optic tract inf. to PGi → osphenes (bright flashing lights)
medial → IC stimulation → facial pulling/muscle twitching
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