Cerebrovascular Disease and Infections Flashcards
ACA lesion?
- upper motor neuron type weakness and cortical type sensory loss
- Initally contralateral hemiplegia
-
contralateral leg more than arm or face
- alien hand syndrome
PCA lesion?
Contralateral homonymous hemianopia
MCA lesion?
- aphasia
- hemineglect
- hemianopia
- face-arm sensoriomotor loss
- gaze preference to side of lesion
ACA-MCA watershed area infarction?
- proximal arm and leg weakness
- transcortical aphasia
MCA-PCA watershed infarction?
Higher order visual processing
Carotid stenosis thrombi symptoms?
- contralateral face arm weakness
- contralateral visual field defeccts
- aphasia
- face arm leg weakness
- contralateral sensory changes
What artery is most affected by embolic infarction?
MCA
____ hemorrhages are characteristic of bone marrow embolization.
Widespread white matter
Heritable coagulation factor disorders?
- protein S or C deficiencyh
- Antithormbin III deficiency
What are the two types of strokes?
- Hemorrhagic
- emboli associated
- hemorrhage secondary to reperfusion of damaged vessels
- Ischemic
- thrombus associated
- hemorrhagic conversion: vessels ruptures leading to secondary hemorrhage
Ischemic stroke mechanisms?
- embolic
- thrombolic
- large vessel such as MCA
- small vessel especially in basal ganglia
- Lacunar infarcts: small vessel infarcts resembling small lakes
What is a lower motor neuron lesion of cranial nerves IX X and XII?
Bulbar palsy
What is the name for a condition that affects your ability to control the miscles in your face, including your jaw?
Psuedobulbar palsy aka involuntary emotional expression disorder
Where is pneumococcal meingitis densest?
over convexitites near sagittal sinus
Where is H. influenzae located in the brain?
Basal location
Focal cerebritis?
- inflammatory cells infiltrate walls of the veins and extend in brain substance
What does leptomeningeal fibrosis lead to?
Hydrocephalous
What is ventriculitis?
- fulminant infection with inflammation that extends to ventricles
Gram stain for N. meningitidis, S. pneumonia, H. influenzae, S.aureus, S. streptococci, E.coli?
- N. meningitidis Gram negative diplococci
- S.pneumoniae gram positive diplococci
- H. influenzae gram negative pleomorphic
- S. aureus and S epi streptococci gram positive cocci
- E. coli gram negative bacilli
Glucose level in CSF if bacteria are present?
Low because bacteria eat glucose
Viral meningitis CSF findings?
- normal pressure
- clear
- early PMNs and Late lymphs
- normal glucose and protein or negative
- 0-500 cells
Bacterial meningitis CSF results?
- increased pressure
- opaque
- 1-60,000 cells
- lots PMNs
- negative glucose
- high protein
3m-2yo unvaccinated with acute meningitis, what is t he cause?
H. influenza type B
Neonate acute meningitis cause?
- E.coli
- Grp B strep
Adolescent and young adult meningitis cause?
- N. meningitidis
Elderly meningitis causes?
- Strep pneumonia
- Listeria
Acute meningitis in an immunocompromised patient is likely caused by…?
- S. pneumonia
- N. meningitidis
- L. .monocytogenes
- P. aeruginosa
Basilar skull fracture meningitis cause?
- S. pneumonia
- H. influenzae
- Grp A beta hemolytic strep
Head trauma post neurosurgery meningitis causes?
- S. aureus
- S. epi
- aerobic gram - bacilli
CSF shunt meningitis causes?
- S. epi
- S. aureus
- P. aeruginosa
- P. acnes
Waterhouse-Friderichsen syndrome?
Hemorrhagic infarction of adrenal glands seen with N. meningitidis
Chronic meningitis CSF results?
- Elecvated protein
- Mostly lymphocytic
- Sometimes low glucose level
HIV is associated with increased incidence of ___?
primary CNS lymphoma
Rash on palms and soles?
- Hand foot mouth
- Kawasaki Dz
- Rocky Mtn spotted fever
- Secondary Syphilis
CNS Rocky mountain spotted fever symptoms?
- diffuse cerebral edema
- meningeal enhancement
- arterial infarction
- signal abnormality within distribution of perivvascular spaces
