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neurology FA + STEP 2 > common brain lesion, aphasia > Flashcards

common brain lesion, aphasia Flashcards

1
Q

aphasia - types

A
  1. Broca 2. Wernicke 3. Conduction 4. Global
  2. Transcortical motor 6. Transcortical sensory
  3. Mixed trancortical
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2
Q

aphasia Broca - manifestation

A
  • Nonfluent
  • intact comprehension
  • impaired repetition
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3
Q

aphasia Broca - area

A

inferior frontal gyrus of frontal lobe

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4
Q

aphasia Wernicke - manifestation

A
  • Fluent
  • Impaired comprehension
  • Impaired repetition
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5
Q

aphasia Wernicke - area

A

superior temporal gyrus of temporal lobe

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6
Q

conduction aphasia - manifestation

A
  • Fluent
  • Intact comprehension
  • Poor repetition
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7
Q

conduction aphasia - area

A

can be caused by damage to arcuate fasciculus

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8
Q

Global aphasia - manifestation

A
  • Nonfluent
  • Impaired comprehension
  • Impaired repetition
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9
Q

Global aphasia - area

A

arcuate fasciculus, Broca and Wernicke areas affected

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10
Q

Transcortical motor - manifestation

A
  • Nonfluent
  • Good comprehension
  • Intact repetition
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11
Q

Transcortical sensory - manifestation

A
  • Fluent
  • Poor comprehension
  • Intact repetition
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12
Q

Mixed transcortical - manifestation

A
  • Nonfluent
  • Poor comprehension
  • Intact repetition
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13
Q

Mixed transcortical - area

A

Broca and Wernicke areas involved.

Arcuate fasciculus not involved

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14
Q

anomic aphasia

A

a selective disorder of naming

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15
Q

common brain lesion - amygdala (bilateral) - manifestations

A

Kluver - Bucy syndrome –> disinhibited behavior:

  1. hyperphagia
  2. hypersexuality
  3. hyperpolarity
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16
Q

Kluver - Bucy syndrome - area of lesion and cause

A
  • amygdala (bilateral)

- HSV-1

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17
Q

common brain lesion - frontal lobe - manifestations

A
  1. Disinhibition
  2. deficits in concentration, orientation and judgement
  3. maybe re-emergence of primitive reflexes
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18
Q

common brain lesion - dominant parietal-temporal cortex

A

GERSTMANN SYNDROME

  1. Agraphia 2. acalculia 3. finger agnosia
  2. left - right disorientation
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19
Q

common brain lesion - nondominant parietal-temporal cortex

A

Hemispatial neglect syndrome –> agnosia of the contralateral side of the world

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20
Q

reticular activating system - area

21
Q

common brain lesions - reticular activating system - manifestations

A

reduced levels of arousal and wakefulness (eg. coma)

22
Q

common brain lesions - frontal eye fields - manifestations

A

Eyes look torward lesion

23
Q

common brain lesions - paramedian pontine reticular formation - manifestations

A

eyes look away from side of lesion

24
Q

common brain lesions - hippocampus (bilateral) - manifestation

A

anterograde amnesia: inability to make new memories

25
Q

common brain lesions - subthalamic lesion - manifestations

A

contralateral hemiballismus: sudden, wild flailing of 1 arm +/- ipsilateral leg

26
Q

common brain lesions - basal ganglia - manifestations

A

tremor at rest
chorea
athetosis

27
Q

common brain lesions - cerebellar vermis - manifestations

A

truncal ataxia

dysarthria

28
Q

common brain lesions - Mamillary bodies (bilateral) - manifestations

A

Wernicke - Korsakoff syndrome: 1. confusion 2. ataxia

  1. ophthalmoplegia 4. memory loss 5. comfabulation
  2. personality changes
29
Q

Wernicke - Korsakoff syndrome - memory loss

A

anterograde and retrograde

30
Q

Mamillary bodies (bilateral) / Wernicke - Korsakoff syndrome can be precipitated by

A

giving glucose without B1 to a B1-deficient patient

31
Q

common brain lesions - cerebellar hemisphere - manifestations

A

at the site of damage:

  1. intention tremor 2. limb ataxia
  2. loss of balance 4. fall toward side of lesion
32
Q

Cerebral hemisphere degeneration is associated with

A

chronic alcohol use

33
Q

frontal eye fields - location / responsible for

A

in the frontal cortex

- non-tracking, voluntary eye movements

34
Q

Hydrocephalus - types

A
  1. Communicating (nonobstructive)
  2. Noncommunicating (obstructive)
  3. Hydrocephalus mimics
  4. normal pressure hydrocephalus (a particular form of communicating hydrocephalus)
35
Q

Hydrocephalus mimics –>

A 
Ex vacuo ventriculomegaly --> appearance of increased CSF on imaging, due to decreased brain tissue (neuronal atrophy), NORMAL ICP
(TRIAD IS NOT SEEN) 
1. Alzheimer disease 
2. advanced HIV 
3. Pick disease 
4. Huntington disease
36
Q

Noncommunicating hydrocephalus is caused by structural blockage of CSF circulation with ventricular system - examples?

A
  1. stenosis of aqueduct of Sylvius

2. colloid cyst blocking foramen of Monro

37
Q

Communicating (nonobstructive) hydrocephalus - types

A
  1. communicating hydrocephalus

2. normal pressure hydrocephalus

38
Q

communicating hydrocephalus - mechanism

A
  1. decreased CSF absorption by arachnoid granulations

2. increased CSF production.

39
Q

communicating hydrocephalus - clinical findings

A
  1. increased ICP
  2. papilledema
  3. herniation
40
Q

Normal pressure hydrocephalus - affects the / causes? / CSF pressure / do not result in

A
  • elderly
  • idiopathic
  • elevated only episodically
  • do not result in increased subarachnoid space volume
41
Q

Normal pressure hydrocephalus causes (and mechanism)

A

expansion of ventricles distorts the fibers of the corona radiata –> triad of 1. urinary incontinence 2. ataxia
3. cognitive dysfunction (sometimes reversible)
(Does not results in increased subarachnoid space volume)

42
Q

ventricular system - direction

A

Lateral ventricle –> 3rd ventricle via right and left interventricular foramina of Monro –> 3rd ventricle –> 4th ventricle via cerebral aqueduct (of Sylvius) –> 4th ventricle –> subarachnoid space via:

  • Foramina of Luschka (lateral)
  • foramina of Mangendie (Medial)
43
Q

idiopathic intracranial hypertension is AKA / definition

A

pseudotumor cerebri

- increased ICP with no apparent cause on imaging

44
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - symptoms and signs

A
  1. headache
  2. diplopia
  3. papilledema
  4. no mental status alternations
45
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - mechanism of diplopia

A

usually from CN VI palsy

46
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - LP

A

increased opening pressure

headache relief

47
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - RISK FACTORS

A
  1. being woman on childbirth age
  2. vitamin A excess
  3. danazol
  4. tetracyclines
48
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - treatment

A
  1. weight loss
  2. acetazolamide
  3. topiramate
  4. invasive procedure for refractory cases
49
Q

idiopathic intracranial hypertension (pseudotumor cerebri) - invasive procedure for refractory cases

A
  1. repeat LP
  2. CSF shunt placement
  3. optic nerve fenestration surgery

neurology FA + STEP 2 (8 decks)

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