Neuro Flashcards
glia
a type of neuron. They make oligodendrocytes, astrocytes, and macroglia
Gliosis
– inflammation in the brain (fibrosis)
-most important indicator of CNS injury
cerebral edema
can be focal (abscess/neoplasms) or generalized (hepatic encepholopathy, Na solution)
MCC of someone going into a coma
MC neural tube defect in newborns
spina bifida
myelomeningocele
extension of meninges and CNS tissue
-check alpha feto protein levels in pregnant pts
Arnold Chiari Malformation
There is a small posterior cranial fossa, with a misshaped midline cerebellum and downward extension of the vermis through the foramen magnum….leads to hydrocephalus
Dandy Walker malformation
enlargement of 4th ventricle, cyst forms, leads to hydrocephalus
polymicrogyria
Too many gyri leads to abnormally developed brain
unilateral-mild seizures to no symptoms
bilateral-seizures, dev delays, eyes misaligned
Holoprosencephaly
– the brain does not have division (brain without separation)
one eye fetus
Agenesis of Corpus Callosum
– two separate brains with no connection
usually presents with epilepsy in first week of life
congenital hydrocephalus
wet wobbly wacky 4th ventricle is blocked MC due to TORCH
concussions
- not associated with anatomic changes in brain
- it is reversible
- no functional loss
contusion
-bruise in brain
coup vs countercoup
injury at site of impact
injury at site opposite of impact
epidural hematoma
- middle meningeal artery most commonly affected when skull is injured
- fractured temporal bone can cause this injury
- it will press the brain downwards, towards the foramen magnum and it will herniate
- seen post trauma, can die two hours later
subdural hematoma
This is a problem with the vein
This is BENEATH the dura
Pt slips, falls, hits his head – complains of headache that is getting worse
common in elderly
AV malformation
– artery and vein are together (artery continues into vein)
- Veins can’t handle the type of pressure that arteries can handle – everything is going to explode BOOM rupture
- at risk for subarachnoid hemorrhage
berry aneurysm
– outpouching of artery, if it continues to out-pouch and ruptures that will cause bleeding
-seen in polycystic kidney disease
3 categories of cerebral vascular disease
Hypoxia > ischemia > infarction
Intraparenchymal hemorrhage
Ruptured Berry Aneurysm and Subarachnoid Hemorrhage
Two types on infarcts
Hemorrhagic (red)
Non-Hemorrhagic (pale)-thrombus formation
intraparenchymal hemorrhage
MCC is HTN, rupture occurs in basal ganglia
subarachnoid hemorrhage
thunderclap headache “worst of life”, straight to CT
subfalcine hernia
transtentorial
cerebellar tonsil
- can compress the anterior circulating artery
- PCA
- presses on medulla, affects breathing
acute meningitis
neonates-E. Coli (gram neg) Group B strep (gram pos) so treat for both gram pos and neg
infants/children-H influenza
young adults-neisseria, most dangerous form, presents with petecchial rash
elderly-S Pne or listeria monocytogenes
meningitis work up
CT scan first to rule out abscess or mass so you don’t herniate the brain when you do the spinal tap
viral-normal glucose, lymphocytes
bacterial-low glucose, neutrophils
MCC of brain abscess
staph or strep
If they do surgery to remove abscess and give ABX, mortality is less than 10%. If they don’t they will eventually herniate and die
Viral meningitis and encephalitis difference
ALTERED MENTAL STATUS IN ENCEPHALITIS
MCC viral encephalitis and others
HSV 1 herpes zoster CMV Poliomyelitis Rabies HIV
Multiple sclerosis
- affects white matter of brain destroying myelin
- leads to fatigue, slow movements
- decreased oligodendrocytes
Alzheimer’s disease
- neurofibrillary tangles
- plaques
- gold standard is autopsy
Parkinson
affects basal ganglia and brainstem, movement disorder
– reduction in voluntary movement AND abundance of involuntary movement
Parkinson has a depletion in….
dopamine….too much Ach causing tremors
Huntington Disease
autsomal dominant, progressive movement disorders with dementia
after dx pt has about 15 years
MC benign brain tumor
meningioma
astrocytoma
80% of adult tumors, always infiltrate brain, looks like part of the brain on CT, may not be deadly
glioblastoma multiforme
grade 4 astrocytoma aka butterfly tumor
affects both hemispheres
worst tumor
oligodendroglioma
can be seen on CT easily bc of calcifications
medulloblastoma
This is bad because it’s really deep in
Very radiosensitive = that’s the good part = radiation therapy
schwanoma
benign tumor, presents with tinnitus
