Neuro 1 Flashcards
what area of the brain is involved with comprehension and understanding of speech? where in the brain is this? what is its main blood supply?
Wernicke’s area.
superior temporal gyrus of the dominant hemisphere.
middle cerebral artery.
what area of the brain is involved with the production of speech? where in the brain is this? what is its main blood supply?
Broca’s area.
frontal lobe of the dominant hemisphere.
middle cerebral artery.
what would be the clinical features of a brainstem infarct?
quadriplegia, disturbances of gaze and vision, locked-in syndrome
what are the 5 different syndromes produced by lacunar infarcts?
ataxic hemiparesis, pure motor, pure sensory, sensorimotor, dysarthria/clumsy hands
if a patient presented with vertigo, headache, ataxia and vomiting, what structure has been affected and what vessel has caused it?
cerebellar syndrome - due to occlusion of superior, anterior inferior or posterior inferior cerebellar artery
what rheumatological disease is giant cell arteritis associated with?
polymyalgia rheumatica
describe the 3 main clinical features of giant cell arteritis, and what causes them
headache - inflamed superficial temporal/occipital artery that hurts to touch and can become tortuous and thickened (I can’t even comb my hair!)
facial pain - inflammation of facial maxillary and lingual branches of external carotid artery, worse on eating (jaw claudication) - I can’t eat steak anymore!
visual disturbance - arterial inflammation and occlusion causing monocular painless visual loss (amaurosis fugax).
what is the risk if treatment of giant cell arteritis is delayed?
irreversible bilateral visual loss.
how would you diagnose giant cell arteritis? what should be done first?
raised ESR/CRP.
temporal artery biopsy - start steroids first!!
how would you treat giant cell arteritis?
immediate high dose oral prednisolone.
in Brown-Sequard syndrome, there is a hemisection of the spinal cord, on what side is there a loss of proprioception, vibration, power, pain and temperature?
contralateral loss of pain and temperature.
ipsilateral loss of proprioception, vibration and power.
what is the genetic basis of Huntington’s chorea? how many repeats may a patient have before they develop Huntington’s?
expansion of CAG repeat on chromosome 4 - overexpression of the huntingtin gene.
> 27 repeats is abnormal.
40 almost definitely will get Huntington’s.
the more repeats, the worse the symptoms.
what is giant cell arteritis?
systemic immune mediated vasculitis affecting medium and large sized arteries
what 3 clinical features make up Cushing’s triad of signs of raised ICP?
irregular resps.
bradycardia.
hypertension.
What is the likely cause of bleeds in the basal ganglia, pons and/or cerebellum?
Hypertension.
