Neuro Flashcards
Concussion
Head trauma
LOC
Retrograde Amnesia
No focal neuro findings
Cushing’s Triad
Describes the physiologic response to rapidly increasing intracranial pressure and imminent brain herniation
- hypertension
- bradycardia
- abnormal respirations
Contusion
Head trauma
LOC
Retrograde Amnesia
No focal neuro findings
CT findings
Epidural hematoma
Convex density
Middle meningeal
Cushing reflex
Increased bp and decreased pulse secondary to increased intracranial pressure
Cold calorics
- normal reflex: rapid nystagmus away from cold ear, with slow return towards cold ear
- in coma with intact brain stem: lacks the nystagmus phase and moves slowly toward cold water
Which plain films should be obtained in a comatose pt?
- c-spine series in pts with suspected trauma
- X-ray chest
Treatment of myasthenia gravis
Pyridostigmine - outpt only. No role in acute setting, because it may lead to muscle weakness at high doses
If suspect myasthenia crises then measure FVC
If FVC <30 cm H2O
These values suggest impending respiratory failure
Febrile seizure: define
x
Complex febrile seizure: define
x
Nimodipine
SAH
Cauda equina syndrome
x
Conus medullaris syndrome
X
stroke involving the MCA: clinical presentation
contralateral hemiparesis with hemisensory loss
the face and arm are usually affected more than the leg
homonymous hemianopsia with lateral gaze towards the lesion
if the dominant hemisphere is inovled, aphasia is usually present
if the nondominant side is affected the pt has contralateral weakness and numbness but might also exhibit inattention, neglect and constructional dressing apraxias
ACA strokes
contralateral leg weakness and milder sensory deficits
any arm weakness is less severe than any arm weakness
may have peserveration on motor and speech testing
basilar artery stroke
infarction of teh ventral pons leading to quadriplegia
can also lead to locked-in syndrome
there is preservation of cortical function
the upper brainstem and higher cranial nerves might also be preserved, so the pt can usually see, and might be able to move the eyes and also blink
posterior cerebral artery stroke
ipsilateral cranial nerve deficit and contralateral extremity deficit
additionally, the motor deficits are on one side of the body and the sensory deficits on the other
febrile seizure
seizure occuring in pts 6 monts to 5 years
associated with a fever, ie 38 C
without signs of intracranial infection or other neurologic dz
simple
- first episode with age b/t 6 mos and 5 years
- lasts 15 mins
- focality of seizure w/ or w/o jacksonian march
- > 1 episode w/in 24 hour period
33% can have another febrile sz
Skull bone most likely to be fx’s in kids
Parietal
