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pilocytic astrocytoma
region, histology, characteristics on imaging (Juvenile) pilocytic astrocytomas usually arise in the ☆cerebellum, brainstem, hypothalamic region, or optic pathways.

Microscopically, pilocytic astrocytomas are well-differentiated neoplasms comprised of ☆spindle cells with hair-like glial processes that are associated with microcysts. These cells are mixed with ☆Rosenthal fibers and granular eosinophilic bodies.

well-demarcated lesion comprised of cystic and solid components (white and red arrows, respectively)
neurology neurosurgery UWorld   HirotoShishido

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orbital apex syndrome a collection of cranial nerve deficits associated with a mass lesion near the apex of the orbit of the eye

視神経，動眼神経，滑車神経，三叉神経，外転神経
ophthalmology neurosurgery 国試   HirotoShishido

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layers of scalp skin
connective tissue
(epicranial) aponeurosis (galea aponeurotica)
loose connective tissue
periosteum
neurosurgery   HirotoShishido

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Picture CN Ⅴ
nurology neurosurgery   HirotoShishido

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main cerebellar fissures primary fissure
horizontal fissure
secondary fissure
posterolateral fissure
neurosurgery   HirotoShishido

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blood flow from superior saggital sinus to internal carotid vein superior saggital sinus→ superior anastomotic vein(Trolard vein)→ Sylvian vein→ cavernous sinus→ inferior petrosal sinus→ internal carotid vein
neurology neurosurgery   HirotoShishido

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When facial nucleus is affected at the level of lower-pons, what nucleus is likely to be affected too? abducens nucleus(CN Ⅵ)
neurology neurosurgery   HirotoShishido

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trigeminal nucleus
homunculus onion-skin pattern

upper portion of nucleus→ innervate A region
lower portion of nucleus→ C region

lateral→ V1 (ophthalmic) region
medial→ V3 (mandibular) region
neurology neurosurgery   HirotoShishido

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trigeminal nuclei mesencephalic nucleus→ reflex proprioception of the periodontium and of the muscles of mastication in the jaw

chief sensory nucleus(mid pons)→ sensation and light touch of the face as well as conscious proprioception of the jaw

spinal trigeminal nucleus(mid pons-C2)→ information about deep/crude touch, pain, and temperature from the ipsilateral face
neurology neurosurgery   HirotoShishido

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damage to the brainstem→What does pyramidial tract sign suggest? the damage is located on the ventral side
neurology neurosurgery   HirotoShishido

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where dorsal colum cross over to the other side at mid medulla
neurology neurosurgery   HirotoShishido

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internal capsule
homunculus anterior→frontopontine, eye movement
genu→corticonuclear,corticospinal
posterior→arm,trunk,leg,optic and auditory radiation
neurology neurosurgery   HirotoShishido

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sympathetic chain
location 1st neuron hypothalamus→ Brown Sequard symdrome
2nd neuron lateral horn(T1) stellate ganglion→ Pancoast tumor
3rd neuron superior cervical ganglion(C2)→ carotid dissection
neurology neurosurgery   HirotoShishido

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four parts of ICA(internal caroted artery) cerebral→ACA,MCA,AChA(ant. choroidal a)→pyramidal tract!!!→Monakow's syndrome, Pcom,OphA
cavernous
petrous
cervical
neurology neurosurgery   HirotoShishido

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which bones joins together at pterion?
what can be caused due to the fracture at pterion? frontal, parietal, temporal, and sphenoid bones

epidural hematoma(caused by the laceration of middle meningeal artery)(→can cause Cushing reflex)
neurosurgery neurology UWorld   HirotoShishido

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