Neuro Review- First Aid- pg 462-465 Flashcards
3rd ventricle –> 4th ventricle via?
cerebral aqueduct (of Sylvius)
lateral ventricle –> 3rd ventricle via?
foramen of Monro
Dx?
- acute blockage of vessels –> disruption of blood flow –> ischemia –> liquefactive necrosis
- 3 types:
- thrombotic (clot in MCS from atherosclerotic plaque)
- emobilic (cardioembolic)
- hypoxic (hypoperfusion/hypoxemia during CV surgery)
- tx = tPA if no hemorrhage
- risk reduction = aspirin, clopidogrel, BP control, blood sugar and lipid control, treat risky conditions like a-fib
ischemic stroke
Dx:
- rupture of bridging veins
- elderly, alcoholics, blunt trauma, shaken baby
- crescent-shaped
- crosses suture lines
- midline shift
subdural hematoma
transient ischemic attack (TIA)
- brief, reversible episode of focal neuro dysfunction
- lasts less than 24hrs
- negative MRI findings
What are the 2 general types of hydrocephalus?
- communicating (nonobstructive)
- noncommunicating (obstructive)
subdural hematoma
- rupture of bridging veins
- elderly, alcoholics, blunt trauma, shaken baby
- crescent-shaped
- crosses suture lines
- midline shift
UMN or LMN signs?
- weakness
- hyperreflexivity
- increased tone
- Babinski
- spastic paralysis
- clasp knife spasticity
UMN
Where do the dural venous sinuses drain?
the internal jugular vein
intraparenchymal (hypertensive) hemorrhage
- cause = systemic HTN, amyloid, vasculitis, neoplasm
- often in basal ganglia and internal capsule
hemorrhagic stroke
- due to HTN, anticoagulation, CA
- 2a to ischemic stroke followed by reperfusion (bc vessels are rigid)
- often at basal ganglia
UMN lesions signs?
- weakness
- hyperreflexivity
- increased tone
- Babinski
- spastic paralysis
- clasp knife spasticity
- *** Upper MN = everything UP (tone, DTRs, toes)
4th ventricle –> subarachnoid space via?
foramen of Luschka = lateral foramen of Magendie = medial
What are the types of communicating hydrocephalus?
- communicating hydrocephalus (decreased CSF absorption –> increased ICP, papilledema, herniation)
- normal pressure hydrocephalus (expansion of ventricles –> distorted fibers of corona radiate –> urinary incontinence, ataxia, cognitive dysfunction)
- hydrocephalus ex vacuo (increased CSF appearance but ICP is normal- due to decreased neural tissue from atrophy)
CSF is made by ____ cells of the _____.
ependymal cells of the choroid plexus
Dx?
- increased CSF appearance but ICP is normal
- due to decreased neural tissue from atrophy
- ex: Alzheimer’s, advanced HIV, Pick disease
hydrocephalus ex vacuo
What is noncommunicating hydrocephalus?
- obstructive- blockage of CSF circulation
- ex: stenosis of cerebral aqueduct
In the descending lateral corticospinal tract, the legs are _____.
lateral (Lumbosacral/Legs are Lateral)
Dx?
- brain bleed
- cause = systemic HTN, amyloid, vasculitis, neoplasm
- often at basal ganglia and internal capsule
intraparenchymal (hypertensive) hemorrhage
Dx?
- rupture of middle meningeal artery (from maxillary a)
- usu. 2a to temporal fracture
- lucid interval
- can cause herniations
- lens-shaped
epidural hematoma
Dx?
- obstructive- blockage of CSF circulation
- ex: stenosis of cerebral aqueduct
noncommunicating hydrocephalus
For lumbar punctures: To keep the cord alive, keep the needle between _____.
L3-L5
LMN lesions signs?
- weakness
- atrophy
- fasciculations
- hyporeflexia
- decreased tone
- flaccid paralysis
- *** Lower MN = everything lowered (less muscle mass, decreased tone, decreased DTRs, downgoing toes)
Dx?
- brain bleed due to HTN, anticoagulation, CA
- 2a to ischemic stroke followed by reperfusion (bc vessels are rigid)
- often at basal ganglia
hemorrhagic stroke
fasciculus gracilis
- dorsal column
- lower body, legs- more medial
CSF is reabsorbed by ____ and then drains into _____.
arachnoid granulations; dural venous sinuses
fasciculus cuneatus
- dorsal column
- upper body, arms - more lateral
Dx?
- brief, reversible episode of focal neuro dysfunction
- lasts less than 24hrs
- negative MRI findings
transient ischemic attack (TIA)
epidural hematoma
- rupture of middle meningeal artery (from maxillary a)
- usu. 2a to temporal fracture
- lucid interval
- can cross falx and tentorium
- lens-shaped
What is hydrocephalus ex vacuo?
- increased CSF appearance but ICP is normal
- due to decreased neural tissue from atrophy
- ex: Alzheimer’s, advanced HIV, Pick disease
Dx?
- rupture of an aneurism or an AVM
- “worst headache of my life”
- bloody or yellow spinal tap
- risk of vasospasm- treat with nimodipine
- fast timecourse
subarachnoid hemorrhage
What is normal pressure hydrocephalus?
expansion of ventricles –> distort fibers of corona radiata –> triad of urinary incontinence, ataxia, cognitive dysfunction (wet, wobbly, wacky)
UMN or LMN signs?
- weakness
- atrophy
- fasciculations
- hyporeflexia
- decreased tone
- flaccid paralysis
LMN
Dx?
expansion of ventricles –> distort fibers of corona radiata –> triad of urinary incontinence, ataxia, cognitive dysfunction (wet, wobbly, wacky)
normal pressure hydrocephalus
subarachnoid hemorrhage
- rupture of an aneurism or an AVM
- “worst headache of my life”
- bloody or yellow spinal tap
- risk of vasospasm- treat with nimodipine
- fast timecourse
ischemic stroke
- acute blockage of vessels –> disruption of blood flow –> ischemia –> liquefactive necrosis
- 3 types:
- thrombotic (clot in MCS from atherosclerotic plaque)
- emobilic (cardioembolic)
- hypoxic (hypoperfusion/hypoxemia during CV surgery)
- tx = tPA if no hemorrhage
- risk reduction = aspirin, clopidogrel, BP control, blood sugar and lipid control, treat risky conditions like a-fib
