CNS Flashcards
What is the MC cause of primary brain parenchymal hemorrhage, and at what age
Hypertension, 60
What is responsible for 15% of deaths in chronic HTN patients
Primary Brain Parenchymal Hemorrhage
What is MC from a ruptured saccular aneurysm, has a fatality rate of 25-50% on the first episode (likely to recur), Often described as “Worst headache I’ve ever had”
Subarachnoid Hemorrhage
What make up 80-90% of all intracranial aneurysms, and are a risk factor for Polycystic kidney disease
Saccular Aneurysm
What is the MC cerebrovascular malformation is a tangle of arteries and veins “worm-like”, and 2x MC in males ages 10-30
Arteriovenous Malformation (AVM)
What is occlusion of a single artery, occurs in deep brain tissues: silent which make it devastating
Lucuna infarct
What is a ruptured small cerebral vessel, hemorrhage, resorbed, “slit-like cavity” remains
Slit Hemorrhage
What is described by global cerebral dysfunction, diastolic BP >130= severe inc. in ICP
Hypertensive Encephalopathy
What is vessel wall inflammation
Vasculitis
What is systemic autoimmune vasculitis, fibrinoid necrosis, small cerebral arteries and heart
Polyarteritis Nodosa
What is chronic inflammation of multiple parenchymal and subarachnoid vessels. MC in males 30-60
Primary Angiitis of the CNS
What is the Tx for vasculitis
Immunosuppression
CNS Trauma has a high morbidity and mortality, who is at greater risk for it
Males 2x
What is trauma that injures neurons and disrupts vessels which leads to hemorrhage (“brain-bruise”)
Gyri are most susceptible
Contusion
What is tearing of cerebral parenchyma that disrupts vasculature that leads to hemorrhage
Laceration
What is movement of one brain region relative to another. Angular acceleration/shaking. Leads to diffuse disruption of white matter
Diffuse Axonal Injury (DAI)
What causes 50% of post-traumatic comas. may not involve direct impact
Diffuse Axonal Injury
What is reversible altered consciousness from head injury in the absence of contusion
Concussion
What percent of concussions recover in 10 days without Tx
80%
Imaging cant ID a concussion, but a CT may be used for what
To rule out hemorrhage
What occurs in the minority of all concussions (15-20%) when symptoms may last for weeks to months
Post-concussive syndrome
Why does Dx. of a concussion exclude from RTP
Second-impact syndrome: second concussion, lethal
What occurs with dural artery damage, compresses brain tissue, lucid during bleed, Associated with Fx, Neurosurgical emergency
Epidural Hematoma
What occurs when rapid movements tear the veins, leading to a subdural bleed which compresses the brain
Subdural Hematoma
Which is the more rare of the dural hematomas
Epidural ~2%
What artery is MC involved with epidural hematoma
Middle meningeal
What % of severe head traumas result in a subdural hematoma
5-25%
What is the MC cause of neural tube defects
CNS malformation
What is an asymptomatic bony defect
Spina bifida occulta
What is extension of CNS through vertebral defect (lumbosacral)
Myelomeningocele
What is an absence of brain, rostral aspect
Anecephaly
What is CNS diverticulum through cranium
Encephalocele
Which spinal cord abnormality is a cavity connected to 4th ventricle
Hydromyelia
Which spinal cord abnormality is when there is a cyst withing the cord, adults
Syringomyelia (syrinx)
What is associated with loss of pain/temp sensation in a “shawl-like” distribution with poss tissue atrophy or areflexia
Syringomyelia
What perinatal brain inj. occurs prematurely, near ventricles, may cause hydrocephalus
Intraparenchymal hemorrhage
What perinatal brain injury occurs prematurly, supratentorial white matter, chalky plaques, possibly cysts
Infarct
What perinatal brain inj. is non-progressive defects in motor neurons (movement disorder
Cerebral palsy
What is the MC way CNS infections are spread
Hematogenous
What is an infection in the epidural space, typically from an adjacent infection (sinusitis, osteomyelitis)
Epidural abscess
What is an infection of the subdural space
Subdural Empyema
What disease is associated with HA, nucal rigidity, and photophobia primarily. Fatal if untreated, favorable with Tx
Acute pyogenic (bacterial) meningitis
What neurological exam for meningitis involves pain when one knee is brought to the chest
Kernig sign
What neurological exam for meningitis involves pain when the heels are brough to the buttocks and head is passively flexed
Brudzinski sign
What kind of meningitis is aseptic
Viral
What are the 2 types of chronic meningitis
Tuberculous and Spirochetal
Parenchymal infections: Localized infection
Bacterial abscess
Parenchymal infections: Diffuse infection
Viral Encephalitis
Parenchymal infections: Local or diffuse (mixed)
Fungal encephalitis
What parenchymal infection is MC among immunosuppressed
Fungal encephalitis
What is a type IV hypersensitivity autoimmune attack on white matter
MS
What is the MC myelin disorder
MS
Who is at greater risk fo rMS
females 2x, familial hx. inc. 15x
What happens during active MS
Ongoing myelin breakdown
What happens during inactive MS
Little myelin and minimal inflamm
What is Wernicke-Korsakoff Syndrome (necrosis of the thalamus) caused by
Thiamine (vit B1.) deficiency
What is LE paresthesia/paralysis and nystagmus
Beriberi
What can a Cobalamin (B12) deficiency lead to
Cord demyelination
What is the MC cause of hypoglycemia
Inappropriate insulin use
What is the MC cause of hyper glycemia
Uncontrolled diabetes
What is the MC cause of dementia in elderly
Alzheimer’s Disease
What is a Parkinsonism
Altered motor function
What does Parkinson disease damage
Dopaminergic neurons, Substantia nigra
What can be seen in Parkinson’s
Lewy bodies
How is Parkinson’s treated
L-DOPA, Deep brain stim (less effective over time)
What condition is chorea (dance-like jerking) of entire body seen in
Huntington’s Disease
What 2 nuclei are effected in huntington’s
Caudate and Putamen
What kind of astrocytoma is malignant, 80% of adult gliomas, 30-60
Diffuse
What kind of astrocytoma is benign, cystic, affect children/youg adults, cerebellum or spinal cord (rarely cerebral
Pilocytic
What kind of glioma is MC in pediatrics (periventricular regions)
Adults=spinal canal
Ependymoma
Medulloblastomas make up what % of pediatric brain tumors
20%
Where is Diffuse Large B Cell Lymphoma MC
Among immunosuppressed (AIDS)
90% of these are benign, MC affects adult females, and made of transformed arachnoid cells
Meningioma
Metastasis into the CNS accounts for what percent of intracranial tumors
25-50% (Lungs, breast, melanoma, kidney, GI)
