NEURO Flashcards
Signs & Sxs:
- Unilateral throbbing pain
- Pain worse with movement or physical activity
- N/V
- Phonophobia, photophobia
Common migraine (w/o aura)
Signs & Sxs:
- Unilateral excruciating, penetrating pain 15 mins-3 hours
- Maximal pain behind eye
- Lacrimation, rhinorrhea, conjunctival injection, congestion
- Pts may pace or exhibit manic behavior
Cluster headache
Signs & Sxs:
- Focal neurological deficit
- Change in speech, visual loss, diplopia
- Numbness or tingling
- Dizziness, HA, confusion, vertigo
- Impaired consciousness
Stroke/CVA
Signs & Sxs:
- Tonic clonic movement
- Post-ictal phase
Grand mal seizure
Signs & Sxs:
- Altered consciousness
- Bizarre sxs
- Nausea
- Dream like states, hallucinations
- Affective disorders
Complex partial seizure
Signs & Sxs:
- Unilateral throbbing pain
- Pain worse with movement or physical activity
- N/V
- Phonophobia, photophobia
- Unilateral paresthesia, numbness, unilateral weakness
- Flashing lights, odors
Classic migraine (with aura)
Signs & Sxs:
- HA
- Photophobia
- Seizures
- Confusion, irritability
- N/V
- Stiff neck
Bacterial meningitis
Signs & Sxs:
- Spacing out
- Myoclonic
- Isolated extremity jerking
Petit mal (absence) seizure
Signs & Sxs:
- Focal neurological deficit
- Change in speech, visual loss, diplopia
- Numbness or tingling
- Dizziness, HA, confusion, vertigo
- Impaired consciousness
- Spontaneous symptom resolution w/in 24 hours
TIA
Signs & Sxs:
- Tightening band-like pressure
- Usually bilateral
- Mild to moderate intensity
- Does not worsen with physical activity
Tension HA
Signs & Sxs:
- No LOC
- Motor or sensory manifestations
- Unilateral tonic clonic
- Numbness, flashing lights, olfactory
Simple partial seizure
Strokes are most common in what group of people?
African American
What is the most common occluded vessel in stroke?
MCA (middle cerebral artery)
Non-modifiable Risk Factors for Stroke
- age
- sex
- race
- FHx
- prior stroke or TIA
Modifiable Risk Factors for Stroke
- smoking
- HTN, DM, hypercholesterolemia
- cardiac dz, a-fib, valvular heart dz, carotid stenosis
- obesity
Tests for Stroke
- glucose
- CBC, INR, lytes
- neuro exam
- MRI
- CT without contrast looks for bleed
When should tPA be given to a stroke patient?
within 3 hours
How does a TIA differ from a stroke?
- similar sxs
- sxs resolve spontaneously
- less than 24 hours
ABCD2 Scale
- age 60+ is 1 point
- BP > 140/90 is 1 point
- Clinical signs: unilateral weakness = 2 pts, speech change w/o weakness = 1 pt
- DM = 1 pt
- Duration: > 60mins = 2 pts, 1-59 mins = 1 pt
- less than 4 = go home
- 4-5 is mod risk and should be admitted
- 6-7 high risk and should be admitted
Tx for TIA
- ASA or clopidogrel
- follow up q3 months for a year then yearly
Migraine Precipitants
- menstruation
- sleep pattern changes
- caffeine withdrawal/excess
- red wine, hard cheese, herring, chocolate
- estrogen (OTC)
- fasting
- stress
- physical activity
Imaging for Migraines
-CT to rule out other causes or if sxs warrant
What consists of a series of HAs lasting 2-3 months, occurring every 1-2 years?
cluster HA
Labs and Imaging for Cluster HA
- ESR
- CT to rule out SAH