Focal Brain Disorders Flashcards

1
Q

what makes up the intracranial tissue volume?

A

brain parenchyma
blood
CSF

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2
Q

what is the most effective compensatory mechanism for volume increase?

A

CSF shifts: shunt caudally, decrease production, increase absorption

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3
Q

is the blood brain barrier disrupted in cytotoxic edema?

A

not initially

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4
Q

what is normal intracranial pressure?

A

less than 20 mmHg

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5
Q

what are the types of brain herniation in dogs due to intracranial disease?

A

cingulate gyrus herniation
caudal transtentorial herniation
foramen magnum herniation

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6
Q

what is transtentorial herniation?

A

caudal displacement of hemispheres ventral to tentorium cerebelli

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7
Q

why is a foramen magnum herniation bad?

A

compresses medulla

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8
Q

what are some clinical signs of foramen magnum herniation?

A

stupor to coma
tetraplegia
non-responsive and dilated pupils
absent physiological nystagmus
respiratory abnormalities

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9
Q

what are some focal space occupying lesions?

A

dermoid, epidermoid cyst
hematoma, hemorrhage
encephalitis focal, abscessation
neoplasia
granuloma

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10
Q

what are two differentials for circling cats?

A

meningioma
stroke

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11
Q

what are some extra-axial bleeding types?

A

epidural hematoma
subdural hematoma

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12
Q

what type of fractures are most common in head trauma?

A

linear fractures

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13
Q

what is there high risk of with basilar skull fractures?

A

nerve damage or entrapment
CSF otorrhea or rhinoorhea

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14
Q

what are some primary brain tumors?

A

meningioma
astrocytoma
oligodendroglioma
plexus papilloma
pituitary adenoma

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15
Q

what are extra-axial tumors mainly?

A

meningiomas

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16
Q

what are common intra-axial tumors?

A

glial tumors
plexus papilloma

17
Q

what are some differentials for intraventricular tumors?

A

plexus papilloma or carcinoma
ependymoma
meningioma

18
Q

what are some etiologies of fungal granulomas?

A

Aspergillus fumigatus
Cryptococcus neoformans
Blastomycosis
Histoplasmosis
Colored fungii

19
Q

what is a stroke?

A

neurological deficits because of cerebrovascular disease

20
Q

what is ischemia?

A

reduction in blood flow to a level incompatible with normal function

21
Q

what are some possible causes of stroke in dogs?

A

often not understood
hypertension, chronic kidney disease, Cushing’s disease, diabetes mellitus

22
Q

what regulates cerebral blood flow?

A

cerebral metabolic rate
local cerebrovascular autoregulation

23
Q

where does vasogenic edema usually happen?

A

white matter

24
Q

does vasogenic or cytotoxic edema respond to hyperosmolar IV fluids?

A

vasogenic edema

25
Q

what is normal mean arterial pressure in the brain and below what is concerning?

A

80-100 mmHg
below 70 mmHg is concerning

26
Q

why is transtentorial herniation a problem?

A

compresses midbrain and rostral cerebellum

27
Q

what can compressing the medulla lead to?

A

respiratory compromise
death

28
Q

what are possible signs of an acute foramen magnum herniation?

A

stupor to coma
tetraplegia
non-responsive and dilated pupils
absent physiological nystagmus
respiratory abnormalities

29
Q

what is the cushing’s reflex?

A

primary brain ischemia
increase in MAP to improve blood flow and oxygen delivery to brain
reflex bradycardia

30
Q

is a hemorrhagic stroke from intra-axial or extra-axial bleeding?

A

intra-axial bleeding

31
Q

what are comminuted fractures like?

A

fragments aligned
depressed bone pieces

32
Q

which antibiotics have good blood brain barrier penetration?

A

metronidazole
enrofloxacin
3rd or 4th generation cephalosporins

33
Q

what is most impacted by cytotoxic edema?

A

gray matter

34
Q

what are the possible signs of acute brain herniation with transtentorial downwards?

A

dullness, stupor, coma
tetraparesis and ataxia
abnormal PLR, anisocoria
abnormal physiological nystagmus

35
Q

what are the possible signs of acute brain herniation with foramen magnum?

A

stupor to coma
tetraplegia
non-responsive and dilated pupils
absent physiological nystagmus
respiratory abnormalities

36
Q

what is of concern with intraventricular tumors?

A

metastatic spread along CSF flow
especially with plexus papilloma or carcinoma

37
Q

where are granulomas often with focal GME in the focal form?

A

brain stem

38
Q

what is the blood supply to the brain?

A

rostral cerebral artery
middle cerebral artery
caudal cerebral artery and perforating arteries
rostral cerebellar artery
caudal cerebellar artery