Conditions CNS

Question 1

Describe the condition of cervical myelopathy

Answer 1

• compression of the Cx spinal cord, can also include compression of spinal nerve roots (radiculopathy)
• usually caused by degeneration of the joints, or any other condition that narrows vertebral canal

SSX:

• both sensory and motor tracts affected
• both upper and lower limbs affected
• bilateral SSX (can distinguish from radiculopathy alone)
• SSX across multiple myotomes and dermatomes
• gait disturbance

Treatment:

• imaging to confirm
• surgery

Question 2

Describe the condition of neurogenic claudication

Answer 2

• compression of Lx spinal nerves in central canal
• normally caused by degeneration narrowing the canal

SSX:

• affects Lx nerves only (not ascending or descending tracts)
• motor and sensory SSX in lower limbs
• SSX increase with anything that puts Lx into extension and narrows vertebral canal

Treatment:

• conservative (rarely surgical)
• pain management

Question 3

What are the two major types of stroke, and the 4 sub-types

Answer 3

Ischaemic (blood blockage) - embolic or thrombolitic

Haemorrhagic (bleeding) - intra-cerebral or subarachnoid

Question 4

Describe the condition of ischaemic stroke

Answer 4

• blood flow to the brain is occluded by a blood clot
• blood clot can originate from within the artery (thrombotic) or elsewhere (embolitic)
• blood clot usually caused by arterial plaque

SSX:

• can be a subtle presentation
• bilateral sensory & motor changes
• difficulty with speech
• difficulty with comprehension
• dizziness
• vision changes
• thunderclap headache
• difficulty swallowing

Question 5

Describe the condition of haemorrhagic stroke

Answer 5

• bleeding from cerebral vessels onto brain tissue
• bleeding can be contained (intra-cerebral) or breach pia mater and enter subarachnoid space (subarachnoid)
• bleeding usually caused by an aneurysm and underlying high BP

SSX:

• quick onset
• thunderclap headache
• sudden lapse of consciousness
• typical stroke SSX
• nausea / vomiting

Question 6

Describe the condition of meningitis

Answer 6

• infection of the meninges of the brain and spinal cord
• can be bacterial (more severe) or viral (less severe)
• bacterial often caused by URTIs
• viral often caused by stomach viruses

SSX:

• severe throbbing HA
• nuchal rigidity
• photophobia

SSX infection (fever, malaise, HA, rash)