Neuro Flashcards
What is ischemic penumbra?
CVA - Area of brain around primary injury that can be salvaged!!!
A patient presents with sensory and motor changes, including aphasia and agnosia. How do you manage?
CVA
Door to doc in 10 min
Door to CT in 25 min
45 min to read CT
A patient comes in with a hemorrhagic stroke. How do you treat? What about ischemic stroke?
Hemorrhagic: Tight BP control: <180/110 with nitroprusside or labetalol
Ischemic: TPA/endovascular treatment
What are the contraindications for TPA use? 6
- Current/Prior hemorrhagic stroke
- Any stroke within past 3 months
- Known intracranial neoplasm, AVM, aneurysm
- Active bleeding (except menses)
- Suspected aortic dissection
- Allergy
10%-25% of pts have stroke within how many months? How many of those occur within the first 2 days?
3 months
1/2
What is the most common cause of sudden death from a stroke?
Subarachnoid hemorrhage
What are the main risk factors for a subarachnoid hemorrhage?
Chronic HTN
Polycystic kidney disease
A patient comes in with a really bad HA, neck stiffness, N/V. How do you manage and tx?
Subarachnoid hemorrhage
Emergent noncontrast CT
Call neurosurg
BP controlled to <160
Reverse anticoags
A patient comes in with a unilateral pulsating HA. How do you treat?
Migraine
Sumitriptan
Antiemetic
Toradol
Fioricet
What is a disease of the elderly and of alcoholics?
Subdural hematoma
What is an acceleration-deceleration injury?
Subdural hematoma
A patient comes in after an MVA. CT shows crescent shaped hematoma. What is it?
Subdural hematoma
What is a disease of the young?
Epidural hematoma
A patient fell on his head. They lost consciousness and then had a lucid interval. What would a head CT show?
Epidural hematoma
Hyperdense, biconvex, ovid, sharply defined bulges in the brain
A patient comes in with complaints of seizures. You note he is on antiepileptic meds. What should you watch out for that causes these continual seizures?
Being on subtherapeutic antiepileptic doses
List the risk factors of seizures
Sleep deprivation
EtOH
Medication noncompliance
A patient presents with seizures. How do you manage?
Fingerstick glucose
A patient is actively seizing. How do you treat?
Place in left lateral decubitus position + lorazepam
A patient presents with meningitis. What symptoms do you look for?
Neck stiffness
HA
Fever
A patient has positive kernig and brudinski signs. What are these and what do they determine
Meningitis
Kernig: pain when extending the knee after flexing it
Brudinski: knee flexion with neck flexion
A <50 yo male presents with meningitis. How do you treat?
Cetriaxone +Vanco
+ IV dexamethasone
A >50 yo male presents with meningitis. How do you treat?
Ceftriaxone + Vanco + Ampicillin (to cover for listeria)
+ IV dexamethasone
List the red flags of back pain
Fever
Leg weakness
Saddle anesthesia
Urinary retention/bowel incontinence
IV Drug use
Anticoagulation
Trauma
A patient presents with backache with progression to localized pain, fever, sweats, rigors, neuro deficits, and AMS. How do you manage?
Epidural abscess
Emergent MIR
