Neuro Flashcards
Timeline for AD?
AD is a slow, progressive disease with cortical atrophy that progresses to personality changes, do not confuse with Pick frontotemporal dementia. Slow and gradual.
Does Lewy respond to dop agonism?
Lewy does not respond to dopa agonism
Most common place brain gets mets from?
The MCC of brain mets is lung CA, suspect in multiple brain densities on CT with h/o of smoking and no other abnormalties
S/s of GBS?
GBS causes ascending paralysis with absent DTR, sometimes sensory involed. CSF is normal other than high protein
How is GBS treated?
IVIg and plamaphoresis
First step in suspected Stroke?
CT before anything in suspected stroke
Where do emboli from Amaurosis Fugax come from?
Embolic from Amaurosis Fugax are usually from carotid bifurcation = get U/S of neck (Hollenhorst plaques)
What lesions are seen in spinal cord damage (UMN or LMN)
Spinal cord damage/acute injury is still an UMN as it happens before synapse at anterior horn (it can cause both injury, just remember spinal cord injury caues UMN too)
What do you get for a suspected ant/central/posterior cord syndrome?
For spinal cord, MRI is best imaging
best imaging for spinal cord?
MRI is best
Anterior cord syndrome associated with what breaks and s/s
Burst fracture and P/T sensation
S/s of intracranial bleed
Progressive syx with s/s of ICP which differentiates it, they progress and there is n/v and mental status deltas which DONT happen in ischemic strokes
What is the MOST IMPORTANT risk for ALL types of stroke?
The most important risk for ALL types of stroke is HTN
HTN is a risk for what strokes
The most important risk for ALL TYPES OF STROKE is HTN
what does a pronator drift mena
prontator drift is a UMN sign for upper extremities, may exist in absence of ther findings
Any suspected stroke first thing to do?
CT BEFORE ANYTHING, then Tpa if
When is ASA used and not tPA in stroke?
6 hours = ASA
3-4.5 = tPA
CT first
Add clop or dypyridamole if on ASA and having another ischemic stroke
What is MRI used for in stroke?
MRI is done AFTER CT and after therapy is started to localize a clot/vasculature that CT cannot pick up
What test shows an upper motor neuron lesion in upper extremities when high suspicion and other s/s may be absent?
Pronator drift
+ pronator drift?
Pronation when held out, if it drops without pronation it is only weakness, shows UMN deficit in upper extremities when other s/s absent
What do ALL stroke patients need within 24 hours?
Aspirin is only agent proven to prevent stroke, and is indicated in all stroke patients within 24hr
When do you suspect anterior cord syndrome
complete loss of function below lesion with P/T sensation loss
Central cord syndrome is associated in what demo?
cervical injury/upper extremities with incomplete paresis and some P/T loss in hyperextension of the elderly
Elderly with upper spondylolisis are predisposed to what spinal injury
Cental cord syndrome