Malformations Flashcards
What is hydromyelia?
Spinal cord abormality. Cavity, connected to 4th ventricle
What is syringomyelia?
(Syrinx). MC. Cyst within cord. adults. Developmental or traumatic, Arnold-chiari malf (type 1).
What is Intraparenchymal hemorrhage:
Prematurity, near ventricles, may cause hydrocephalus
What are some features of an infarct (malformation)?
Prematurity, supratentorial white matter, chalky plaques, possible cysts.
What is cerebral palsy?
Non-progressive defects in motor neurons (movement disorder)
What are some features of cerebral palsy?
Damage during cerebral development
Prematurity, hypoxia, infection, etc
1/3 have decreased congnition or seizures
How may bacteria, viruses, and fungi travel within the nervous system?
Hematogenous (MC), direct implant (trauma), local extension (mastoiditis, teeth), PNS (rabies, VZV)
What is an epidural abscess?
Adjacent infection (sinusitis, osteomyelitis) -> epidural space. Cord compression, neurosurgical emergency
What is a subdural empyema?
Infection of skull or sinus -> subdural space: emergency. Accumulation of pus.
What are some features of a subdural empyema?
SOL (accumulation of pus), thrombosis, infarct. Pyrexia, HA, cervicalgia, neuro dysfxn. Lethargy, coma.
How do you distinguish meningitis of the leptominiges (arachnoid from pia)?
CSF examination
What are some features of acute pyogenic meningitis?
Bacterial. Very rapid onset. HA, nuchal rigidity, photophobia (3 features known as meningism).
Also, iirritability, pyrexia, decreased congnition, neuro dysfxn. Fatal if untreated. Favorable with tx.
What are some features of the CSF in acute pyogenic meningitis?
Bacterial culture, increased pressure, increased neutrophils, increased proteins (exudate), decreased glucose.
What is found in the subarachnoid space in acute pyogenic meningitis?
Pus, exudate, neutrophils
What condition can a cerebral abscess possibly found in?
Acute pyogenic meningitis?
What is aseptic (viral) meningitis?
Relatively acute onset, pyrexia, consciousness, nuchal rigitidy, edema.
T/F
Aseptic meningitis must be stopped via medical intervention
False,
Self-limiting. CSF: increased lymphocytes
How does chronic meningitis onset?
Insidious onset.
What is spirochetal meningitis?
Third degree syphilis or lyme disease. Neuronal loss (tabes dorsalis), progressive loss of cognition and physical function (ataxia, anesthesia), polyneuropathies, encephalopathy.
What is tuberculous (chronic) meningitis?
HA, malaise, confusion, vomiting. Tuberculoma in brain. CSF: moderate increased WBC’s and proteins
What is a bacterial abscess?
Parenchymal infection. Localized, liqufactive necrosis. Bacerial: spesis, endocarditis, pulmonary infxn. Progressive neuro destruction, increased ICP.
What is viral encephalitis?
Diffuse, from meningitis, mononuclear WBCs, neuronophagia. Rabies virus, poliovirus, rubella, west nile, HSV-1, HSV-2, VZV, CMV, HIV
What is a fungal parenchymal infection?
Localized or diffuse (mixed) granulomas, meningitis, MC in immunosuppressed. Candida albicans, aspergillus fumigatus
What are some features of poliovirus (poliomyelitis)?
Gastritis. Grey matter: cord/brainstem. Motor neuron damage. Wasting, flaccidity.
What is MS?
Idiopathic/autoimmune, white matter demyelination. MC disorder of myelin
What are some features of MS?
Episodes of neurologic deficits. “Relapsing-remitting” neurological dysn (acute attacks that come and go). Incomplete recovery.
What happens to myelin with MS?
Chronic inflammation: lymphocytes, macrophages. White matter lesions (plaques).
Who is at risk for MS?
Young adults, females (2x), family HX. (15x) 25% monozygotic twins, decrease for dizygotic. HLA-DR2
What are some primary features of MS?
Episodes of neurologic deficits. “Relapsing-remitting” neurological dysn (acute attacks that come and go). Incomplete recovery.
Who is at risk for MS?
Young adults, females (2x), family HX. (15x) 25% monozygotic twins, decrease for dizygotic. HLA-DR2
Where do plaques of MS occur?
Anywhere in the CNS. MC cerebrum, near ventricles, optic nerve/optic chiasm, brainstem, spinal cord, cerebellum
What are the two types of MS plaques?
Active: Ongoing myelin breakdown
Inactive: Little myelin and minimal inflammation
What are some other features of MS?
Highly variable, progressive
What are some characteristics of early stage MS
Unilateral vision impariments/diplopia. CN dysfxn, ataxia, motor/sensory impairments. Bowel/bladder dysfxn, sexual dysfxn. Seizures, decreased cognition, depression, etc.
What is the management plan for MS?
No cure: I.V. corticosteroids. Immunosuppression: decrease relapses. Many patients report use of CAM
What are some features of Thaimine deficiency?
Wernike-Korsakoff syndrome, confusion, memory, ataxia, chronic alcoholics, chronic gastritis; necrosis, macrophages in thalamus
What is beriberi?
LE paresthesia, paralysis, nystagmus.
What are some features of Thaimine deficiency?
Wernike-Korsakoff syndrome (encephalopathy, memory dysfunction), confusion, memory, ataxia, chronic alcoholics, chronic gastritis; necrosis, macrophages in thalamus
What is beriberi?
Systemic effects of thiamine deficiency. LE paresthesia, paralysis, nystagmus.
What CNS affects are found with Cobalamin deficiency?
Demyelination, “subacute combined degeneration of the spinal cord” (destroys ascending and descending tracks in the cord), ataxia, paraplegia.
What are some affects of hypoglycemia?
Mimics global hypoxia (edema), hippocampus is susceptible to injury
What are some affects of hyperglycemia?
Uncontrolled DM, hyperosmal state (glycosuria, decreased H20), confusion, stupor, coma.
What are some affects of hyperglycemia?
Uncontrolled type II diabetes, hyperosmal state (glycosuria, decreased H20), confusion, stupor, diabetic coma.
