Neuro IV Flashcards
lateral medullary syndrome
PICA stroke
- vomiting, vertigo, nystagmus
- loss pain/temp I/L face and C/L body
- dysphagia, hoarseness
- loss gag reflex
- I/L horners syndrome
lateral pontine syndrome
AICA stroke
- vomiting, vertigo, nystagmus
- paralysis of face
- decreased lacrimation and salivation
- loss taste anterior 2/3 tongue
facial nucleus
medial medullary syndrome
anterior spinal artery stroke
C/L hemiparesis - upper and lower limb
C/L proprioception loss
I/L hypoglossal loss
PCA stroke
C/L hemianopia with macular sparing
occipital cortex
visual cortex
basilar artery stroke
preserved consciousness and blinking
quadriplegia
loss voluntary face, mouth, tongue movement
anterior communicating artery lesion
visual field defect
often aneurysm - not stroke
posterior communicating artery lesion
CN III palsy - eye down and out
lesions aneurysm - not stroke
berry aneurysm
rupture - subarachnoid bleed
-worst headache of life
bitemporal hemianopia - if compress optic chiasm
association berry aneurysm
ehler danlos
ADPKD
risk fx - age, HTN, smoking, AAs
charcot bouchard microaneurysm
with chronic HTN
affect small vessels
basal ganglia and thalamus
central post stroke pain syndrome
pain from thalamic lesion
initial paresthesia - followed by allodynia
allodynia - ordinary painless not painful
epidural hematoma
rupture middle meningeal a
-fx of temporal bone
get lucid interval
football shaped
transtentorial hernation
can get CN III palsy
subdural hematoma
bridging vein rupture
slow bleed
shaken baby, elderly, alcoholic
crescent shaped
subarachnoid hemorrhage
rupture berry aneurysm
ehler danlos, ADPKD
worst headache of my life
bloody spinal tap
stop vasospasm after SA hemorrhage
CCB - nimodipine
intraparenchymal hemorrhage
HTN hemorrhage
timescale ischemia to brain
12-48 hours - red neurons 24-72 hours - necrosis and neutrophils 3-5 days - macrophages - microglia 1-2 weeks - reactive gliosis - vasc proliferation more than 2 weeks - glial scar
irreversible - 5 minutes
stroke imaging
noncontrast CT - before tPA - rule out hemorrhage
most susceptible brain to ischemia
hippocampus, neocortex, cerebellum, watershed
hemorrhagic stroke
MC site - basal ganglia
ischemic stroke of brain
get liquefactive necrosis
1 - thrombotic
2 - embolic
3 - hypoxic
tx - tPA
TIA
reversible episode focal neuro dysfxn
no infarction
resolve
dural venous sinuses
superior sagittal - top
straight - middle - branch to inferior sagittal
transverse - lateral
occipital - inferior
sigmoid - from transverse - to the jugular foramen
-forms internal jugular vein
ventricular system
foramen of monro - lateral to 3rd ventricle
cerebral aqueduct of sylvius - 3rd to 4th ventricle
luschka and magendia - 4th ventricle to SA space
foramen of luschka - lateral
foramen of magendie - medial
CSF production
ependymal cells of choroid plexus
pseudotumor cerebri
idiopathic intracranial HTN
-HA, diplopia, papilledema
often woman, vit A excess
-high open pressure lumbar puncture - relief
tx - weight loss, acetazolamide, topiramate
communicating hydrocephalus
decreased arachnoid granulation absorption
normal pressure hydrocephalus
CSF pressure elevated episodic
urinary incontinence, ataxia, cognitive dysfxn
wet wobbly and wacky
noncommunicating hydrocephalus
obstructive
colloid cyst -monro
stenosis - sylvius
nerve exit spinal cord
cervical - C1 to 7 - exit above vertebrae
C8 - exit below vertebrae
rest of thoracic and lumbar - exit below vertebrae
annulus fibrosis
outer ring - vertebral disc
spinal cord length
to L1-2
SA space to S2
puncture - L3-L5 - level of cauda equina
dorsal column
ascending
pressure, vib, touch, proprio
gracilis - medial - lower body, legs
cuneatus - lateral - upper body, arms
decussate medulla
to VPL
lateral corticospinal tract
descending
voluntary motor
medial cervical
lateral sacral
decussate caudal medulla - pyramidal decussation
to NMJ
lateral spinothalamic tract
ascending
pain and temp
cervical medial
sacral lateral
decussate anterior white commissure - ascend C/L
to VPL
anterior spinothalamic tract
ascending
crude touch, pressure
