Neuro Flashcards
PC:
- CONTRA weakness or sensory loss
- homonymous hemianopsia– looking towards side of lesion
- aphasia
MCA
if you are right handed…
L dominant lobe
- handedness
- speech center
PC:
- personality and confusion
- urinary incontinence
- legs> arms
ACA
PC:
- IPSI sensory loss face, 9th, 10th CNs
- CONTRA sensory loss limbs
- limb ataxia
PCA
best initial test for stroke
non-contrast CT
diagnostic tests for stroke
- ECHO- PFO, surgical valve, thrombus
- EKG
- Holter
- carotid doppler– degree of stenosis
tx for haemorrhagic stroke
NO TX
tx for ischaemic stroke less than 3hrs
thrombolytics
tx for ischaemic stroke greater than 3hrs
aspirin
tx for ischaemic stroke greater than 3hrs and already on aspirin
ADD dipyridamole
or SWITCH to clopidogrel
additional tx to add in for stroke
statins!
experimental window for thrombolytics
3-4.5hrs
carotid angioplasty and stenting
NOOOOOOO proven benefit
ALWAYS the wrong answer
% carotid stenosis and tx
less than 50%= no tx
greater than 70%= endarterectomy
PC pseudotumor cerebri
RICP and CN 6 palsy
risk factors for pseudotumor cerebri
- obese young female
- venous thrombosis
- OCP
- vit A excess
dx for pseudotumor cerebri
LP increase pressure
tx for pseudotumor cerebri
- weight loss
2. acetazolamide
tx for cluster headaches
- triptans
- octreotide
- ergotamine
- 100% oxygen, lithium, prednisone= ABORTIVE, not for mgiraines
cluster prophylaxis
verapamil
prednisone
valproate
best preventitive tx for migraines– if 3 attacks/month
propanolol
valproate
tx trigeminal neuroalgia
oxcarbazepine or carbamezapine
trigeminal neuralgia that doesn’t improve with medication
gamma knife surgery
postherpetic neuralgia pain tx
- TCA’s
- gabapentin
- pregabalin
- carbamezapine
- phenytoin
- topical capsaicin