neuro Flashcards
meningioma on imaging
- well circumscribed, hyperdense,
- extra-axial –> “rim enhacning” suggests CSF surrounding it
- dural tail
- parafalcine
hearing loss assoc with mineiere’s
low freq
what should you think about before treating cluster head aches with sumitriptan or ergots?
are they smokers or have other reasons to have CVD? Sumitriptan and ergots cuse vasoconstriction
AchE inhibitors that DO NOT cross BBB
pyridostigmine
neostigmine
when are steroids indicated in meningitis?
when strep pneumo is known or confirmed?
bull’s eye maculopathy
seen in chloroquine toxicity (malaria, rhematoid/ lupus flair)
most common meningitis bug in adults?
strep pneumo
treatment for acute spinal cord injury?
IV methylpred!!!!!!
not dexamethasone
evidence of spinal shock after traua and absence of bulbocavernous reflex… next step?
foley, or else they will develop acute urinary retention
treatment options for strabisums
occlusion tx= patching the good eye
penalizatoin (cyclopentolate drops)= blur vision, use them in the good eye to force use of bad eye
morton’s neuroma (intermetatarsal neuroma)
usu entrapment of median plantar nerve, caused by narrow heels
sensorineural hearing loss, rinne test
lateralizes to GOOD ear
conduction hearing loss, rinne test
lateralizes to BAD ear because there’s fluid or something that can conduct sound better
cerebellopontine syndrome
most commonly from vestibular schwannoma
- unilateral sensorineural hearing loss
- tinitus
- vertigo
you suspect SAH, but CT is clear and pt has no signs of inc ICP. What do you do?
LP –> RBCs, xanthochromia, maybe elevated opening pressure
how can you distinguish traumatic LP from SAH?
successive tube collections –> number of RBC will stay the same in SAH
mycotic aneurysm
due to septic emboli, most likely from infectious endocarditis
most common cause of non traumatic SAH?
saccular aneuryms rupture= 80%
avm~ 10%
what would an AVM rupture look like on CT?
foci of calcification and hyperattenuating vessels
kernohan’s phenomenon
“false localizing sign”
-uncal herniation of one side causes IPSILATERAL paralysis due to compression of the contralateral cerebellar peduncle
but why exactly does HTN lend highest risk to atraumatic ICH?
htn –> lipohyalinosis of arterioles –> creates microaneurysms –> more weak spots
posterior fossa mass assoc with obstructive hydrocephalus in children
ependymomma
periorbital edema, chemosis, abducens (or other) palsy post sinus like infection?
cavernous sinus thrombosis –> give heparin immediately
central retinal artery occlusion. How is this diff from presentation of optic neuritis? How should you manage it?
sudden loss of vision, APD, macular changes (retinal pallor indicating ischemia, cherry red spots)
- optic neuritis would present as above with NO macular changes
- CRAO= eye ball massage, inhalation of 95% O2, sublingual nitroglycerin
demographic at risk for malignant otitis externa
diabetics –> tx with high dose IV FQ
