Neuro Flashcards
Infarction of which artery can lead to locked in syndrome?
Basilar artery
Most important risk factor of a haemorrhagic stroke?
HTN
Presentation of Wallenberg syndrome (lateral medullary syndrome)?
DANVAH
D - Dysphagia (ipsi)
A - Ataxia (ipsi)
N - Nystagmus (ipsi)
V - Vertigo (ipsi)
A - Anaesthesia i.e. sensory loss (ipsi face, contra body)
H - Horner’s syndrome (ipsi)
What is thrombolysis done with in ischaemic stroke?
Alteplase
What is involved in 2ary prevention of ischaemic stroke (not due to AF)?
Following 2 weeks aspirin 300mg:
1) Clopidogrel 75mg lifelong (or aspirin + dipyridamole)
2) Atorvastatin 20-80mg
When must patients have presented within to have thrombolysis in ischaemic stroke?
4.5 hours of onset of stroke symptoms
A stroke affecting which artery presents with oculomotor nerve palsy (‘down and out’)?
Weber’s syndrome –> branches of posterior cerebral artery that supply the midbrain.
Referral for specialist assessment in TIA:
a) <7 days since TIA
b) >7 days since TIA
a) within 24 hours
b) within 1 week
Mechanism of alteplase?
Tissue plasminogen activator
What is a posterior inferior cerebral artery infarct also known as?
Lateral medullary syndrome / Wallenberg’s
When is a carotid endarterectomy considered in TIA or stroke?
Should only be considered if carotid artery stenosis is >70%
Mx of TIA?
Aspirin 300mg 2 weeks
Followed by lifelong clopidogrel 75mg
What scoring system measures disability or dependence in ADLs in stroke patients?
Barthel index
What blood tests are involved in ‘young’ people with stroke?
i.e. <55 y/o with no obvious cause of stroke
Thrombophilia & autoimmune screening
When is thrombectomy considered in ischaemic stroke (alongside thrombolysis)?
If <4.5h from onset AND confirmed occlusion of the proximal anterior circulation
Most likely mx of symptomatic chronic subdural bleeds?
Burr hole evacuation
When is an S3 heart sound normal?
<30 y/o
What medications can be used in the prophylaxis of migraines? (3)
1) propanolol
2) amitriptyline
3) topiramate
What condition is trigeminal neuralgia associated with?
MS
Which antiepileptic can cause SIADH?
Carbamazepine
1st line antiepileptic for focal seizure?
Lamotrigine or levetiracetam
When are antieplileptics started in the majority of cases?
After the 2nd epileptic seizure
What is involved in the mx of infantile spasms? (2)
1) ACTH
2) Vigabatrin
What condition may atonic seizures be indicative of?
Lennox-Gastaut syndrome