Neuro Flashcards
TACS stroke and criteria
Total Anterior Circulation Stroke
Limbs, eyes, brain function (dysphasia/visuospatial)
All three of the following need to be present for a diagnosis of a TACS:
Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)
Characteristic feature of tuberous sclerosis
Typical features
Neuro features
How do u get it?
The characteristic feature is the development of hamartomas, which are benign tissue growths. Hamartomas cause problems based on the location of the lesion. They commonly affect the:
Skin
Brain
Lungs
Heart
Kidneys
Eyes
Skin features include:
Ash leaf spots (depigmented areas of skin shaped like an ash leaf)
Shagreen patches (thickened, dimpled, pigmented patches of skin)
Angiofibromas (small skin-coloured or pigmented papules that occur over the nose and cheeks)
Ungual fibromas (circular painless lumps that slowly grow from the nail bed and displace the nail)
Cafe-au-lait spots (light brown “coffee and milk” coloured flat pigmented lesions on the skin)
Poliosis (an isolated patch of white hair on the head, eyebrows, eyelashes or beard)
Neurological features include:
Epilepsy
Learning disability
Brain tumours
autosomal dominant genetic condition
partial anterior circulation stroke (PACS) criteria
Two of the following need to be present for a diagnosis of a PACS:
Unilateral weakness (and/or sensory deficit) of the face, arm and leg
Homonymous hemianopia
Higher cerebral dysfunction (dysphasia, visuospatial disorder)*
*Higher cerebral dysfunction alone is also classified as PACS.
posterior circulation syndrome (POCS)
One of the following need to be present for a diagnosis of a POCS:
Cranial nerve palsy and a contralateral motor/sensory deficit
Bilateral motor/sensory deficit
Conjugate eye movement disorder (e.g. horizontal gaze palsy)
Cerebellar dysfunction (e.g. vertigo, nystagmus, ataxia)
Isolated homonymous hemianopia
lacunar stroke (LACS)
subcortical stroke that occurs secondary to small vessel disease. There is no loss of higher cerebral functions (e.g. dysphasia).
One of the following needs to be present for a diagnosis of a LACS:
Pure sensory stroke
Pure motor stroke
Sensori-motor stroke
Ataxic hemiparesis
B. Burgdorferi is what?
Lyme disease
What is Bell’s palsy?
7th cranial nerve, facial nerve palsy. (Forehead affected)
What is Bell’s palsy?
7th cranial nerve, facial nerve palsy. (Forehead affected)
What is horners syndrome?
Interruption of the sympathetic supply to the face: ptosis(droopy eye), miosis(constricted pupil), anahidrosis(lack of sweat)
Third nerve palsy looks like what and what would be the keen thing for us to rule out?
Eye down and out. Rule out brain annuyerism
Dizziness could be due to what vessel stenosis/occlusion?
Vertebral, as they supply the cerebellum which is responsible for balance
Amaurosis fugax and what is it associated with
Temporary loss of vision in one eye
Carotid artery stenosis, want to do sometching about it asap because it can lead to a huge stroke.
Sister if Mary josef nodule is where and what is it a sign of?
Red/purple lump in belly button. Sign of ovarian cancer so it needs to be ultrasounded
How can you pin down timeframes?
=patient hx
Collateral hx
Notes
Important event eg did you have this at. Christmas
What are the scores for he MRC scale
0 **no contraction **
1 contraction, no movement
2 movement, not overcoming gravity
3 active movement that can over come gravity
4 active muscle movement against gravity
5 normal muscle strength
Start off by assessing if they can overcome gravity
Lmn elision eg myopathy where seen
Shoulders and hips
What is a pyramidal pattern of weakness and is it a sign of umol or lil?
Upper motor lesion:
Flexion stronger than extension arms
Legs extension better than flexion
What things do you need to work through in surgical sieve
5I 3-Scotland
Where “3-Scotland” relates to the three top killers in Scotland.
I: infection
I: inflammation
I: immune
I: iatrogenic
I: idiopathic
1: vascular/cardiovascular
2: cancer
3: trauma
Fasiculation umn or lmn sign and what likely?
Lmn sign and often mnd (both upper and lower motor neuron signs j
Causes of black out
cardiac
Syncope
Vasovagal
Aortic stenosis
Arrhythmia
Postural hypotension
Dis function.
endo
Low blood sugar
brain
Epilepsy
Rare (collie cyst, migraine but might cause vasovagal)
Mind
Psychologically mediated: panic attack/disociation (non epileptic attack, pseudoseizure)
Metabolic
How to tell the difference between epileptic seizures and dissociative seizures
Dissociative ; grandmal , seizure like BUT has consciousness
Prolonged unconsciousness
What is a colloid cyst?
Pedunculated cyst that can flop and block cns fluid outflow
Argument with partner then black out. What is that indicative of ?
Dissociative seizures
Generalised tonic clinic seizure timeframe
Vs
Dissociated seizures
Fitting 2-5 minutes
Unresponsive with obstructive breathing 2 minutes
Confused for 30 minutes
Longer seizure time, come to rapidly following. If they happen a lot they can be variable
