Cerebrum

Question 1

What are the differentials covered in the damnitv acronym?

Answer 1

Degenerative
Anomalous
Metabolic
Neoplastic or nutritional
Idiopathic or inflammatory
Traumatic or toxic
Vascular

Question 2

T/F: know drug dosages for neuro

Answer 2

False!

Question 3

CS of cerebral dz

Answer 3

Behavior changes, mentally inappropriate
Head turn and circling (ipsalateral)
Menace deficits contralateral, abnormal nasal sensation
Deficits in proprioception contralateral
Spinal reflexes and tone normal
Pain possible over calvarium

Question 4

Hx and CS for cerebrum

Answer 4

Seizure
Behavior change
Cerebrum and thalamus show similar clinical symptoms

Question 5

Degenerative diseases of cerebruM

Answer 5

Storage diseases dt enzymatic defects

CS: personality change, ataxia, tremor, paresis, vision impairment

Question 6

Dx and Tx of degenerative dz

Answer 6

Dx: peripheral blood, bone marrow, or CSF may reveal vacuolated leukocytes
Metabolic tests
Histopath is definitive

NO tx

Question 7

Cognitive dysfunction syndrome

Answer 7

Similar to alzheimer’s

Accumulation of beta amyloid

Question 8

Dx of canine cognitive dysfunction syndrome

Answer 8

DISHA
Disorientation
altered Interactions
Sleep wake cycle alterations
House-soiling
altered Activity level
MRI - brain atrophy, ventricular enlargement

Question 9

Tx of CDS

Answer 9

No cure
L deprenyl
Prognosis poor in long term

Question 10

Anomalous cerebrum

Answer 10

Congenital hydrocephalus
Caudal occipital malformation
Etc

Question 11

Congenital hydrocephalus

Answer 11

Excessive CSF in brain

Question 12

Causes of congenital hydrocephalus

Answer 12

Obstruction of flow of CSF
Decreased absorption
Increased production: more often with tumors
Acquired can occur secondary to inflammation causing decreased absorption (distemper)

Question 13

CS of congenital hydrocephalus

Answer 13

Persistent sutures and fontanels
Dome shaped head
Smaller than littermates
Seizures
Slow learners
Ventrolateral strabismus with normal PLRs and Physiologic nystagmus

Question 14

Dx of congenital hydrocephalus

Answer 14

CS
MRI
CT
US

Question 15

Tx of congenital hydrocephalus

Answer 15

Medical management
- Decrease CSF production
- Prednisone
- Omeprazole (proton pump inhibitor)
- Furosemide
- Acetazolamide
SX

Question 16

Congenital hydrocephalus prognosis

Answer 16

Variable but guarded

Post Sx complication rate 20-30%

Question 17

Intracranial arachnoid diverticulum

Answer 17

CS: wide clinical presentation, cerebrum or vestibulocerebellar dysfunction

Question 18

Diverticulum Dx and Tx

Answer 18

Dx MRI

Tx similar to hydrocephalus

Question 19

Lissencephaly

Answer 19

Reduced gyri
Seizures
No tx

Question 20

Polymicrogyria

Answer 20

Excessive small gyri
Seizures
no Tx

Question 21

Hepatic encephalopathy

Answer 21

Build up of neurotoxins
- Caused by portosystemic shunt, hepatic organ failure, hepatic microvascular dysplasia
CS: median age 12 mo, obtunded, abnormal behavior, head pressing, visual deficits and rarely seizure

Question 22

Dx of hepatic encephalopathy

Answer 22

Blood testing: CBC, Chem
Bile acids
Elevated blood ammonia
Imaging: Portogram, US, scintigraphy, MRI or CT

Question 23

What are the pseudo liver function tests?

Answer 23

Glucose
Cholesterol
Albumin
BUN

ALL DECREASED in Hepatic issues

Question 24

Hepatic encephalopathy Tx

Answer 24

Medical: decrease neurotoxins (lactulose, Abx, diet), decrease seizures
Sx
Variable prognosis

Question 25

Hypoglycemia

Answer 25

``` Decreased BG alters neuronal function (insulinoma, storage disease, young toy breeds) CS: seizures, blindness Dx: Acute BG <60, chronic <30 Tx: treat underlying Prognosis variable ```

Question 26

Sodium disturbance

Answer 26

``` Hypernatremia = hyperosmolality Shrinkage of brain -> stretch BV -> hemorrhage Correct slowly to prevent cerebral edema Hyponatremia = hypoosmolality Can lead to swelling of brain ```

Question 27

Primary brain tumors

Answer 27

``` Older pts Goldens and boxers CS: Referable to tumor location - Dogs in cerebrum (seizures) - Cats in cerebrum (mentation change) ```

Question 28

Meningioma

Answer 28

Most common brain tumor in cats and dogs From arachnoid layer of meninges Histologically benign

Question 29

Gliomas

Answer 29

Most common brain tumor in people, second most common in dogs Arise from supporting cells of the brain parenchyma Histologically more aggressive

Question 30

Choroid plexus tumors

Answer 30

Arise form the choroid plexus - Ventricles - Hydrocephalus is common dt overproduction of CSF Histologically variable

Question 31

Dx and tx of primary brain tumors

Answer 31

Imaging (MRI) Biopsy CSF analysis Sx Radiation therapy Chemotherapy Palliative

Question 32

Secondary brain tumors

Answer 32

Dogs: hemangiosarcoma, pituitary, lymphoma, metastatic carcinoma, invasive nasal tumors Cats: Lymphoma Pituitary

Question 33

Nutritional

Answer 33

Thiamine deficiency

Question 34

Idiopathic

Answer 34

Epilepsy | Narcolepsy/cataplexy

Question 35

Inflammation in the CNS

Answer 35

Meningitis (meninges) Encephalitis (brain) Myelitis (spinal cord)

Question 36

Fungal infection

Answer 36

Inhalation Crypto, coccidioides, blasto, histo, aspergillus CS: young to middle aged, slow progression, encephalopathy common Dx: presence of organism in extraneural site, Imaging, Ab testing Tx: Medical Sx