CNS patho 2 Flashcards
Cingulate (subfalcine) herniation under falx cerebri:
Can compress ____
anterior cerebral artery.
Central/downward transtentorial herniation
rupture of paramedian basilar artery branches → Duret hemorrhages.
Uncal transtentorial herniation
Early herniation: ipsilateral blown pupil (unilateral CN III compression), contralateral hemiparesis (cerebral peduncle compression - Crus cerebri)
Uncal herniation sequence
CN III compression
Further progression → loss of vestibular-occular reflexes and decorticate followed by decerebrate posturing
UMN lesion
weakness in lower limb _____ and upper limb _____ and _______
LL: Flexors
UL: Extensors and supinators
Spinal motor atrophy: Defect and mutation?
mutation in SMN1 → defective snRNP assembly → degradation of anterior horn cells
LMN lesion symptoms only
SMA type 1 is called
Werdnig-Hoffmann disease
Amyotrophic lateral sclerosis Can be caused by defect in____
superoxide dismutase 1.
Amyotrophic lateral sclerosis Also called
Lou Gehrig disease.
Amyotrophic lateral sclerosis: macroscopic findings
Thin anterior root
Mild atrophy of precentral gyrus
Amyotrophic lateral sclerosis: most common cause of death
Respiratory complication i.e aspiration pneumonia
___________ supplies ASA below T8
artery of Adamkiewicz
Frataxin is a _________ encoded by _____ nucleotide repeats on chromosome number ______
Iron-binding protein, GAA
9
Mesial temporal sclerosis is associated with _____
childhood febrile seizures
Auras are ______
simple, partial seizures
________ differentiates seizure from cardiac syncope
Post-ictal state
Myoclonic jerks on awakening from sleep is a hallmark of ______
Juvenile myoclonic epilepsy
_____ is used for refractory epilepsy
Ketogenic diet
Causes of seizures by age:
Children
Adults
Elderly
Children—genetic, infection (febrile)
Adults—tumor, trauma, stroke
Elderly—stroke, tumor, trauma,
Absence seizure treatment according to onset
Early onset: Ethosuxamide Later onset (10-12): Valproic acid
> 42.2’C (108 F) _____
Oxidative phosphorylation stops
Distortion in patient’s sense of position (eg feeling of floating, changes in position) or visual interpretation (eg size of objects) due to damage of _________
Non-dominant parietal lobe
Cluster headache treatment
acute
prophylaxis
Acute: sumatriptan, 100% O2.
Prophylaxis: verapamil.
Migraine treatment
acute
prophylaxis
Acute: TEN NSAIDs, triptans, dihydroergotamine. Prophylaxis: BBAT VA lifestyle changes (eg, sleep, exercise, diet), β-blockers, amitriptyline, topiramate, valproate, botulinum toxin, anti-CGRP monoclonal antibodies
Tension headache treatment
acute
prophylaxis
Acute: analgesics, NSAIDs, acetaminophen. Prophylaxis: TCAs (eg, amitriptyline), behavioral therapy.
Horner syndrome in which type of headache
Cluster
Patients with medically intractable essential tremor treated with ____
High frequency stimulation of ventral intermediate nucleus (VIN) of thalamus
Subthalamic nucleus lesion (contralateral):
High frequency Deep brain stimulation suppression of subthalamic nucleus is done in _____
Hemiballismus
Parkinson disease
Rubral tremors
At rest and goal directed activity
Combined lesion of midbrain, substantia nigra and superior cerebellar peduncle
Restless leg syndrome: pathology
Associated with
Functional iron deficiency: Low iron concentration in substantia nigra even in absence of systemic iron deficiency
Iron deficiency and CKD
