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Clinical Neuroscience 2 > Clinical- 6 > Flashcards

Clinical- 6 Flashcards

1
Q

Which nerve innervate the anterior/middle fossa?

A

V

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2
Q

Which nereves supple the posterior fossa?

A

IX and X

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3
Q

What are the common causes of acute headaches?

A 
SOMATIC DYSFUNCTION UP IN THIS BITCH
Subarachnoid Hemorrhage
Other Cerebrovascular diseases
Meningitis/encephalitis
Ocular Diseases (glaucoma)
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4
Q

What are the common causes of Subacute headaches?

A 
Giant Cell (temporal) arteritis
Intracranial Mass (tumor, subdural hematoma, abcess)
Pseudotumor cerebri (benign intracranial hypertension)
Trigeminal neuralgia
Glossopharyngeal neuralgia
Postherpetic neuralgia
Hypertension 
Atypical Facial Pain
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5
Q

What are the common causes of chronic headaches?

A 
Migraine
Cluster Headache
Tension headache
Cervical Spine Disease
Sinusitis
Dental Disease
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6
Q

Subarachnoid hemorrhage (SAH)- causes

A

ruptured berry aneurysm from sites of branching arteries. can be from AV malformations too. polycystic kidney disease is assocaited with berry aneurysms

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7
Q

SAH- Sx

A

Worst headache ever. new headache. ↑ BP, global Sx (except AVMs and PCA aneurysms).

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8
Q

SAH- Dx

A

CT for confirmation, CSF has blood, u can do a cerebral arteriography

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9
Q

SAH- Tx

A

↓ BP. Nimodipine blocks Ca channels to reduce vasospasm. Surgery for mild cases

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10
Q

SAH- complications

A

recurrence, intraparenchymal extension, ischemia from arterial vasospasm, hydrocephalus, szrs

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11
Q

SAH- prognosis

A

60% die within the 1st day, but survivors can be either in a coma or Sx free. 1/2 have brain dmg.

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12
Q

Giant cell arteritis (GCA)- cause

A

granulomatous inflammation of the external carotids (sup temporal a.), women > 55

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13
Q

GCA- Sx

A

pain in jaw during chewing, blindness in 50% of pts

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14
Q

GCA- Dx

A

Bilateral biopsy for patchy inflammation, ESR is ↑↑↑

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15
Q

GCA- Tx

A

initially it’s prednisone (antinflamm)

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16
Q

GCA- consequences

A

blindness is irreversible

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17
Q

Intracranial mass- Sx

A

headaches with different Sx depending on where the mass is and what the mass it.

Key: bifrontal pain, worse ipsilaterally, worse when u change position, worse when you INCREASE ICP (pooping, sneezing, coughing)

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18
Q

Intracranial mass- Dx

A

CT/MRI right away

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19
Q

Intracranial mass- Tx

A

removal of the offending lesion via surgery, radiotherapy, chemotherapy.

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20
Q

Idiopathic intracranial HTN (IIH)- cause

A

unknown, so u gotta rule out other disorders that cause intracranial HTN

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21
Q

IIH- Sx

A

headache, papilledema, visual loss, floaters, blurring, diplopia, pulsatile tinnitus

22
Q

IIH- Dx

A

rule everything out by CT/MRI/LP. optic nerve sheath dilation is key.

23
Q

IIH- Tx

A

acetazolamide or furosemide

24
Q

Trigeminal neuralgia- cause

A

vascular compression of V

25
Q

Trigeminal neuralgia- Sx

A

pain in V2/V3 region of the face, super hyperalgesia

26
Q

Trigeminal neuralgia- Dx

A

nothing really. the vascular structures are too small to see

27
Q

Trigeminal neuralgia- Tx

A

use of carbamazepine, or phenytoin (IV for acute attacks, oral for regular use); Lamotrigine or baclofen for refractory cases

28
Q

Postherpetic neuralgia- cause

A

Herpes Zoster reactivation of VZV, specifically in a dermatome fashion, occurs mostly in older >70 patients

29
Q

Postherpetic neuralgia- Sx

A

severe buring pain in a dermatome, usually V1, scarring

30
Q

Postherpetic neuralgia- Dx

A

Hx of VZV infection, decreased sensations

31
Q

Postherpetic neuralgia- Tx

A

ACV, corticosteroids, tricyclics for the pain

32
Q

Migrane- cause

A

intracranial vasoconstriction and extracranial vasodilation, pulsatile headaches that have premonitory symptoms (mood, appetite), affects mostly women, and has familial history

33
Q

Migranes- Tx

A

simple analgesics (ASA, otc stuff), ergot preparations (ergotamine, caffeine), narcotics, 5HT agonists

34
Q

Migraines- prophylactics

A

NSAIDS, tricyclics

35
Q

Migraines- precipitating factors

A

foods, tyramine containing foods, hotdogs, cheeses, nitrites, food additives like MSG, and a variety of other

36
Q

Migraines with aura- pathogenesis

A

migrane preceeded by aura, called a classic migraine

37
Q

Migraines with aura- Sx

A

throbbing, unilateral headache with signs of N/V, etc. gradual onset

38
Q

Migraines with aura- Dx

A

Increased white matter lesions

39
Q

Migraines w/o aura- Dx

A

compression of ipsilateral carotid or superficial temporal artery

40
Q

Transformed Migraine- pathogenesis

A

episodic migraine that changes into a daily occurance over a period of months/years

41
Q

Transformed Migraine- Sx

A

varies between migrane-like or tension headache

42
Q

Cluster headache- epidemiology

A

more men than women, at around 25, no familial history, and are always unilateral, and seems to originate from the hypothalamic grey area

43
Q

Cluster headache- Sx

A

burning sensation over lateral aspect of nose or pressure behind the eye, conjunctival injection, ptosis, lacrimation, nasal stuffiness, and horner syndrome also present

44
Q

Cluster headache- acute Tx

A

sumatriptan, Zolmitriptan nasal spray, dihydroergotamine

45
Q

Cluster headache- prophylaxis

A

verapamil sustained release, ergotamine, prednisone, lithium

46
Q

Cluster headache- preceipitation

A

alcohol

47
Q

Tension Headache- cause

A

unknown

48
Q

Tension headache- Sx

A

tight band of pain around head, contraction of neck/scalp muscles,

49
Q

Tension headache- Tx

A

same as migraine - Acute Attack - aspirin, NSAIDs, acetominophen, ergotamine, dihydroergotamine; prophylaxis - amitriptyline or imipramine (DO NOT use SSRI’s)

50
Q

Tension headache- precipitation

A

stress/hunger

Clinical Neuroscience 2 (16 decks)

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