Neuro Flashcards
Lumbar Puncture Indications
Meningitis Meningoencephalitis Subarachnoid hemorrhage Malignancy – Diagnosis and Treatment Idiopathic Intracranial Hypertension
Contraindications for Lumbar Puncture
Cardiovascular or Respiratory instability
Localized skin/soft tissue infection over puncture site
Unstable bleeding disorder
Platelets < 50,000 or clotting factor deficiency
Increased intracranial pressure
MCA Occlusion
Contra-lateral - Paralysis of face/arm/leg - sensory loss face/arm/leg Homonymous hemianopia Gaze paralysis to the opposite side
Aphasia if stroke on dominant (left) side of brain
Dysarthria, Dysphasia
Unilateral neglect and agnosia for half of external space if non-dominant stroke (usually right side).
ACA Occlusion
Contra-lateral
Paralysis of foot and leg
Sensory loss over foot and leg
Impairment of gait and stance.
PCA Occlusion
Syncope
Vertigo
Diplopia
Stroke Causes
Thromboembolism
Raptured Aneurysm
Thrombosis, Atheroma
Total Anterior Circulation Stroke (TACS)
= / - Sensory and Motor Loss
Hemianopia + Dysphasia
Or Hemianopia + Neglect
Partial Anterior Circulation Stroke (PACS)
+ / - Sensory and Motor Loss
Hemianopia
Or Dysphasia
Or Neglect
Commonest Place for Thrombus
Left Atrium
Stroke Teratment
Aspirin, Clopidogrel - AntiPlatelet
Warfarin - Anti Coagulant
IV TPA - Thrombolysis (<= 4 Hours)
Hemiplegia
paralysis of one side of the body
Multiple Sclerosis
Autoimmune - Type 4 Hypersensitivity Reaction
Risk Factors:
Female, Away from equator, Younger, HLA-DR2
Signs: Cerebellar + Sensory Signs, Nystagmus
Internuclear Ophalmoplegia
Symptoms: Diplopia, Limb Weakness, Sensory Weakness, Lhermittes’s Sign (electric sensation down spine)
Lumbar Puncture, (High Protein, ImG, Oligoclonal Bands
White Plaques on MRI
Optic Neuritis
Colour Vision Disturbed
Initial Swelling of Optic Disc
Sub-acute
Pain on moving eye
Inter-nuclear Opthalmoplegia
Pons
Bad Prognosis of MS
Male, Older, Multifocal, Motor Symptoms
MS Treatment
Steroids
Interferon-B
Tremor, Pain and Urinary Incontinence Drugs
Alzheimer’s
B amyloid plaques and tangles
Progressive memory loss