Neuro Geriatrics Flashcards
MC type of dementia
AD
pathophys of AD
amyloid beta protein
neurofibrillary tangles (tau)
acetylcholine deficiency
sx AD
short term memory loss (first sx)
cognitive deficits
dx AD
clinical
MRI - cortex atrophy
tx AD
acetylcholinesterase inhibitors - Donepezil, Rivastigmne, Galantamine
NMDA antagonist - memantine
most important RF for vascular dementia
HTN
sx vascular dementia
sudden decline in function with stepwise progression of sx
dx vascular dementia
clinical
MRI may show infarcts; CT may show lacunar infarcts
another name for frontotemporal dementia
pick’s disease
what is frontotemporal dementia
brain degeneration in the frontotemporal lobes due to pick’s bodies (round or oval aggregates of tau protein)
sx frontotemporal dementia
marked change in personality and language
disinhibition or socially inappropriate behaviors
difference btwn diffuse Lewy body dz and Parkinson dz
Lewy bodies are localized in PD
sx diffuse Lewy body dz
recurrent visual histology
cognitive fluctuations
Parkinsonism
dementia - late finding
epidural hematoma is MC due to
rupture of the middle meningeal artery - associated with temporal bone fx
sx epidural hematoma
brief loss of consciousness –> lucid interval –> neuro deterioration
uncle herniation - CN3 palsy – fixed, dilated, blown pupil
Cushing reflex - HTN, bradycardia, repiratory irregularity
dx epidural hematoma
CT - convex lens shaped hyper density that does not cross suture lines
MCC subdural hematoma
rupture of cortical bridging veins
usually elderly and/or alcholic
dx subdural hematoma
CT - concave crescent shaped bleed that can cross suture lines
MCC subarachnoid hemorrhage
ruptured saccular (berry) aneurysm at the ACA (circle of willis)
most important RF subarachnoid hemorrhage
cigarette smoking
HTN
also polycystic kidney dz
if someone has a head injury what should you always look for
retinal hemorrhage (funduscopy)
LP for subarachnoid hemorrhage
xanthochromia - yellow to pink CSF due t breakdown of RBCs
elevated RBC count that does not diminish from CSF tube 1 to tube 4
type of inheritance of essential tremor
autosomal dominant
sx essential tremor
intentional tremor MC in UE and head
tremor worse with action
postural tremor (hold affected body part against gravity)
tremor improved with alcohol
