Neuro Flashcards
Posterior reversible encephalopathy syndrome
B/l vasogenic edema
HA, AMS, visual disturbance, seizure
Treat: Lower blood pressure (labetolol or nicardipine)
Dix-Hallpike
Pt upright, head 45 degrees, lay down. (+ if nystagmus)
CSF fungal menigitis
Elevated opening pressure
Lymphocyte predominance
Low glucose (<60% serum level)
Anterior cord syndrome
Caused by flexion of vascular injury
Loss of motor, pain and temp below injury
Retain proprioception and vibratory
Poor prognosis
Central cord syndrome
Caused by forced hyperextenion
UE > LE sensory and motor deficits
Brown-Sequard syndrome
Caused by penetrating trauma
Ipsilateral loss of motor, vibratory and proprioception
C/L loss of pain and temperature
Good prognosis
Dementia with parkinson’s features
Lewy body
Cerebral venous sinus thrombosis
Pts with prothrombic states
Headache, visual changes, papilledema
MRI with venography
Give heparin
Stroke in right frontal cerebral cortex
Leg weakness and numbness (ACA)
Stroke of middle cerebral artery
Temporal, parietal, internal capsule and posterior frontal lobe
CL hemiparesis, facial droop, sensory loss
Dominant lobe involvement will cause aphasia
Posterior stroke
Ataxia, nystagmus, dysarthria
CSF viral meningitis
Normal opening pressure, lymphocytic predominance, normal glucose, negative cultures
Epidural hematoma
Side blow
Middle meningeal
Talk and die
Reduce IC pressure, seizure prophylaxis
Wernicke-Korsakoff
Wernicke leads to Korsakoff
Thiamine (B1), pyridoxine (B6), and folate deficiency
Confabulation, gait disturbance, opthalmaplegia
Korsakoff had amnesia
What to give in hyporeflexia etc in refeeding syndrome
IV phosphorus
Normal pressure hydrocephalus treatment?
High volume CSF removal
Classic presentation of headache associated with tumor
Worse upon awakening, worsened by Valsalva maneuver, positional, and associated with N/V
Idiopathic intracranial hypertension
Obese women ages 20 to 44
HAs, transient vision disturbances, back pain, and pulsatile tinnitus
Can lead to permanent vision loss
Oral acetazolamide 250 to 500 mg twice a day
Criteria to diagnose temporal arteritis
What to do in ER
> 50, new headache, temporal artery abnormality, ESR >50
Empiric treatment with oral prednisone 60 mg daily, consult optho
Symptoms of anterior cerebral artery stroke
Contralateral leg weakness and sensory changes
Symptoms of middle cerebral artery stroke
Contralateral hemiparesis (arm > leg), facial plegia, and sensory loss
Symptoms of basilar artery occlusion
Oculomotor signs, Horner’s syndrome, and rarely, a “locked-in” state
Dosing tpa
0.9 mg/kg IV, with a maximum dose of 90 mg; 10% of the dose is administered as a bolus, with the remaining amount infused over 60 minutes
ICP reduction
Head elevation to 30°, analgesia, and sedation
Osmotic diuretics or intubation with neuro- muscular blockade with mild hyperventilation
Glioblastoma on imaging
Irregular, heterogenous lesion with peripheral enhancement
Spread along corpus colosum: butterfly glioma
Medulloblastoma
Most common malignant tumor in kids
Form in cerebellum: dizziness, N/V, CN VI palsy
Glioblastoma
Most common tumor in adults
Rapid onset of symptoms (<3 months)
Korsakoff
Due to thiamine deficiency
Confabulations, apathy, short term memory loss
Decompression sickness
In 6 hours of diving
Bends/chokes/staggers
Hyperbaric chamber
