Neuro Flashcards
what is a swallow screen?
assessment of swallow within 4 hours NICE
> safe swallow to avoid aspiration pneumonia
transjugular intrahepatic portosystemic shunt is what?
causes blood to bypass the liver and enter the systemic circulation wo
metabolism of nitrogenous waste - ammonia
hoovers sign is?
organic / fake paresis of leg
> conversion disorder
positive result : functional weakness
> patient is unable to extend their leg and to press heel into bed
but when the normal leg is lifted you can feel the extension of ‘weak’ leg
in a stroke that affects left leg > arm/face where is the lesion most likely?
CONTRALATERAL side so RIGHT
anterior cerebral artery
>
posterior cerebral artery right sided impact
left eye has a homonymous hemianopia
macular is spared
agnosia
what is weberes syndrome?
right side
bracnh of the posterior cerebral artery
supplies the MIDBRAIN
> ipsilateral CN III palsy : RIGHT eye
> left arm/leg
function of cranial nerve 3?
eye movements
pupil constriction
1) extraoccular muscles
2)sphincter pupillae and ciliary muscles
3) eyelid: superior tarsal muscle
oculomotor nerve palsy
ptosis : drooping eyelid
> levator palpabrae superioris
> unopposed action of orbicularis oculi
Down and out
>elavte no
>depress no
> adduct eye no
Dilated pupil
Motor function of the CN III
superior branch?
superior rectus
levator palpabrae superioris
Inferior branch of CN 3?
inferior rectus > depresses eyeball
medial rectus > adducts (look inwards)
inferior oblique > elevate, abduct and laterally rotate
PICA
posterior
inferior
cerebral artery
Right artery
Right side
> face pain and temp loss
Left
leg / torso pain and temp loss
ataxia
nystagmus
AICA
anterior
inferior
cerebellar artery
lateral pontine syndrome
right artery
Right side
> face pain and temp loss
Left
leg / torso pain and temp loss
ataxia
nystagmus
+ deafness
+paralysis face
COCP / Stroke / Migraine with aura
oestrogen is hypercoagulable
> vasodilatory
Migraine
> vasodilatory and increase RF for stroke
Horner’s syndrome
small pupil
ptosis
sunken eye ENOPTHALMOS
anhidrosis : loss of sweating
causes of Horner’s syndrome
loss of sweating of face / arm and trunk
central lesion
stroke
syringomyelia
MS
tumoyr
encephalistis
causes of Horner’s syndrome
Anhidrosis of the face only
pancoast tumour
thyroidectomy
trauma
cervical rib
NO anhidrosis
horner’ cause
post ganglionic
carotid artery dissection
carotid aneurysm
CVT
cluster headache
vestibular neuronitis
> viral infection
recurrent vertigo attacks hours/days
nystagmus present
NO hearing loss
Mx
> prochlorperazine
Brain Abscess Triad
Fever
headache
focal neurological deficit
seizure
Mx of brain abscess?
surgical : craniotomy abscess cavity debrided
oedema : hypodense
IV 3rd gen cephalosporin nd metronidazole
dexa
stroke types?
1) unilateral hemiparesis / hemisensory loss of the face, arm and leg
2) homonymous hemianopia
3) higher cognitive dysfunction
total anterior circulation infarcts mean?
middle and anterior cerebral arteries
partial anterior circulation infarcts?
involves smaller arteries of anterior circulation e.g. upper or lower division of middle cerebral artery
2 of the above criteria are presen
subdural haematoma
Bridging dural veins
_______ are the most sensitive scan to diagnose diffuse axonal injury
MRIs
what is vestibular neuronitis?
inflammation of vestibular nerve
vertigo
but no hearing loss
features of acoustic neuroma?
vertigo
hearing loss
tinnitus
absent corneal reflex
tumour compressing CN VIII
compression of CN V is why absent corneal reflex
a central cause of vertigo would have ______ nystagmus
vertical
HINTs Exam
head impulse test
> catch up saccade : VN
>normal : stroke
nystagmus: unidirectional : VN
test of skew: abnormal suggest stroke
what is a neurally mediated syncope?
reflex
vasovagal
situational
carotid sinus syncope
isolated hemisensory loss is a feature of?
Lacunar infarct
new generation of COCP have increased what side effect?
VTE events
pontine haemorrhage
reduced GCS
paralysis
bilateral pin point pupils
intracerebral haemorrhage
htn
> penetrating ateries from the basilar extending into pons to rupture
