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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
Trigeminal neuralgia- Sx
pain in V2/V3 region of the face, super hyperalgesia
26
Trigeminal neuralgia- Dx
nothing really. the vascular structures are too small to see
27
Trigeminal neuralgia- Tx
use of carbamazepine, or phenytoin (IV for acute attacks, oral for regular use); Lamotrigine or baclofen for refractory cases
28
Postherpetic neuralgia- cause
Herpes Zoster reactivation of VZV, specifically in a dermatome fashion, occurs mostly in older >70 patients
29
Postherpetic neuralgia- Sx
severe buring pain in a dermatome, usually V1, scarring
30
Postherpetic neuralgia- Dx
Hx of VZV infection, decreased sensations
31
Postherpetic neuralgia- Tx
ACV, corticosteroids, tricyclics for the pain
32
Migrane- cause
intracranial vasoconstriction and extracranial vasodilation, pulsatile headaches that have premonitory symptoms (mood, appetite), affects mostly women, and has familial history
33
Migranes- Tx
simple analgesics (ASA, otc stuff), ergot preparations (ergotamine, caffeine), narcotics, 5HT agonists
34
Migraines- prophylactics
NSAIDS, tricyclics
35
Migraines- precipitating factors
foods, tyramine containing foods, hotdogs, cheeses, nitrites, food additives like MSG, and a variety of other
36
Migraines with aura- pathogenesis
migrane preceeded by aura, called a classic migraine
37
Migraines with aura- Sx
throbbing, unilateral headache with signs of N/V, etc. gradual onset
38
Migraines with aura- Dx
Increased white matter lesions
39
Migraines w/o aura- Dx
compression of ipsilateral carotid or superficial temporal artery
40
Transformed Migraine- pathogenesis
episodic migraine that changes into a daily occurance over a period of months/years
41
Transformed Migraine- Sx
varies between migrane-like or tension headache
42
Cluster headache- epidemiology
more men than women, at around 25, no familial history, and are always unilateral, and seems to originate from the hypothalamic grey area
43
Cluster headache- Sx
burning sensation over lateral aspect of nose or pressure behind the eye, conjunctival injection, ptosis, lacrimation, nasal stuffiness, and horner syndrome also present
44
Cluster headache- acute Tx
sumatriptan, Zolmitriptan nasal spray, dihydroergotamine
45
Cluster headache- prophylaxis
verapamil sustained release, ergotamine, prednisone, lithium
46
Cluster headache- preceipitation
alcohol
47
Tension Headache- cause
unknown
48
Tension headache- Sx
tight band of pain around head, contraction of neck/scalp muscles,
49
Tension headache- Tx
same as migraine - Acute Attack - aspirin, NSAIDs, acetominophen, ergotamine, dihydroergotamine; prophylaxis - amitriptyline or imipramine (DO NOT use SSRI's)
50
Tension headache- precipitation
stress/hunger

Clinical Neuroscience 2 (16 decks)

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