Central Nervous System Flashcards
Pathology in the frontal lobe of the brain
Anosmia (loss of sense of smell)
Inappropriate emotions
Expressive dysphasia (difficulty putting words together for meaning)
Motor impairment
Pathology of the parietal lobe
Receptive dysphasia
Sensory impairment
Pathology of the temporal lobe
Cortical deafness
Receptive dysphasia
What is cerebrovascular disease
Disease incorporating strokes, TIAs, intracerebral haemorrhage
What are the two main pathological processes of cerebrovascular disease?
- Hypoxia, ischaemia and infarction due to impaired blood supply/oxygenation
- Haemorrhage from CNS vessels
If blood flow is reduced to a portion of the brain, what does tissue survival depend on?
- Collateral circulation
- duration of ischaemia
- magnitude and rapidity of flow reduction
What causes generalised neuronal dysfunction?
Global Hypoperfusion (reduced blood flow to whole brain)
Definition of Transient Ischaemic Disease (TIA)
Characterised by temporary loss of function that resolves itself within 24hrs “mini stroke”
How do you treat TIA?
Anti-platelet therapy: aspirin or clopidgrel
Controlling BP
Lower cholesterol
Definition of Stroke
Loss of function lasting greater than 24hrs
Causes of Stroke
Ischaemic: hypoxia of brain (due to blockage of blood vessel by atheroma or embolism)
Haemorrhagic: Bleed in brain (hypertensive related, Berry aneurysm)
Risk factors of a Stroke
Hypertension, diabetes, heart disease, previous TIA, hyperlipidaemia
Management of a Stroke
Thrombolysis, Aspirin/Clopidgrel, Physio, OT, SALT, Supportive Treatment
Signs/symptoms of Dementia
Memory loss, slow speed of thought/language/understanding/judgement, people can become disinterested in usual activities, have difficulties controlling emotions.
Causes of Haemorrhagic Events (Strokes)
Hypertension, vascular malformation (Berry aneurysm), neoplasia, trauma, drug abuse
Intracerabral Haemorrhage definition
“haemorrhagic stroke”
when a diseased blood vessel in the brain bursts
Signs/symptoms of Intracerbral Haemorrhage
Presents as headaches with rapid or gradual loss of consciousness
What is a Subarachnoid Haemorrhage?
Spontaneous and often catastrophic bleed on the brain. Often occurs during physical effort or straining
Signs/Symptoms of a subarachnoid haemorrhage
sudden agonising headache, meningitis-like symptoms/stroke-like symptoms
What is a Subdural Haemorrhage?
Blood collection between the dura and arachnoid space. Bleeding from the bridging veins between the cortex and venous sinuses.
What is an extradural haemorrhage?
Post head injury, build of blood between the dura mater and the skull. Often with a fractured temporal or parietal bone, typically the middle meningeal artery.
Causes of Alzheimer’s Disease?
Neurofibrillary tangles and plaques, and loss of neurones and synpases/
Signs and symptoms of Alzheimers?
Defects of visual-spacial skill (gets lost)
Memory loss
Decreasing cognition
Ansognosia (lack of awareness)
Definition of epilepsy
A recurrent tendency to spontaneous, intermittent, abnormal electrical activity in part of the brain, manifests as seizures.
Management of epilespy
Lifestyle changes, drug compliance (Sodium valproate, carbamazepine, phenytoin, lamotrigine
Types of Meningitis
Bacterial (Niesseria Meningitides, Pneumococcus, Meningococcus)
Viral
Fungal
What is a brain abscess?
Focal infection, which can lead to focal brain damage or mass effect. Can present with headaches, seizures, temperatures.
How does a brain abscess spread?
Via blood - embolus from bacterial endocarditis, IV drug user at risk
Or directly - from an infected inner ear
What is Parkinson’s Disease?
Movement disease that can be sporadic or familial. Postural instability due to the progressive degeneration of the dopaminergic nigrostriatal system and other neuronal networks.
Treatment of Parkinson’s Disease
MDT approach
L-dopa e.g. Madopar
Anticholinergic drugs e.g. orphenarine
Clinical presentation of Parkinson’s disease
Rigidity, bradykinesis, resting tremor, postural instability
Types of Tumours
Bening tumors - can cause problems depending on location and mass effect.
Malignant
Can affect the skull, the meninges or the brain itself
What are meningiomas?
Benign tumour that is generally well circumscribed, and slow growing. Derived from meningothelial cells. They enlarge slowly, don’t often infiltrate the brain and can be removed surgically.
